Children's home run by Bettercare Keys Ltd

Inspection report children’s home: 1256365 1 Registered provider: Bettercare Keys Limited Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

This is a privately owned children’s home which is registered to provide care and accommodation for up to four young people who may have emotional and/or behavioural difficulties.

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Information about this children’s home

Inspection dates: 25 to 26 September 2017

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Overall experiences and progress of

children and young people, taking into account

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inadequate

How well children and young people are helped and protected inadequate

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inadequate

The effectiveness of leaders and managers inadequate

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inadequate

There are serious and widespread failures that mean children and young people are not protected and their welfare is not promoted or safeguarded.

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inadequate

Overall judgement at last inspection: not applicable

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inadequate

Enforcement action since last inspection: not applicable Inspection report children’s home: 1256365 2

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Key findings from this inspection

This children’s home is inadequate because:

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Key findings from this inspection

 Transition procedures completed when the new company took over the running of the home were poor. Young people were not informed in a timely manner and did not have an opportunity to communicate their feelings about the changes taking place.  Since the home was taken over by this provider on 1 July 2017, young people have endured significant change. The new staff team and manager have left the service. The home is currently run by an acting manager and there is no permanent staff team.  Relationships between young people and staff are not developed. Young people seldom engage with staff in a positive manner.  Residential care plans are not updated or reviewed in order to guide staff in their work with young people. Staff are not always aware what the aims of each young person’s placement are.  Educational attendance and attainment have declined. There are no strategies in place to help young people return back to, and succeed in, full-time education.

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Key findings from this inspection

 Young people refusing education are not suitably challenged. Consequently, young people are not motivated to attend school on a consistent basis.  Young people’s health is compromised in the home. Young people who are on supervised monies are provided with unsupervised finances. This has resulted in them frequently purchasing cannabis and on two occasions class A substances resulting in emergency medical evaluation.  Young people who are on controlled medication do not have this reviewed within a reasonable timescale to ensure the effectiveness of this medication.  Young people know how to complain and have raised seven complaints since the home has been taken over. Procedures for managing complaints have not been adhered to. Consequently, none of the complaints raised have been suitably investigated in order to secure a positive outcome for young people.  Parents and social workers are not provided with information pertinent to the care

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Key findings from this inspection

of their child. Communication is poor. Parents are not included in the development and review of their child’s care within the home.  Safeguarding practice in the home is significantly flawed as a result of inconsistent practice, staffing and management. Serious safeguarding concerns have not been suitably notified to statutory partners.  Risk assessments are not updated or reviewed to include the significant changes Inspection report children’s home: 1256365 3 in behaviour of the young people living in the home.  Physical intervention training is not consistently undertaken by staff. This has resulted in a young person being restrained by unqualified staff with the potential to cause harm. One complaint regarding an injury as a result of a restraint has not been followed through.  While Regulation 44 visits are undertaken and reports highlight some of the concerns raised at this inspection, there is no evidence of how these matters have

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Key findings from this inspection

been addressed by the provider.  Senior managers and the placing local authority have not taken effective action to ensure that young people receive consistent, good-quality care.

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Key findings from this inspection

 Most young people have regular contact with family members.  Bedroom decor is chosen by the young people. Bedrooms are suitably decorated.  Regulation 44 external monitoring takes place and reports highlight some of the shortfalls within the service.

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Recent inspection history

This is the home’s first inspection since re-registration. Inspection report children’s home: 1256365 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 meeting the quality standards, the registered person must ensure that staff seek to involve each child’s placing authority effectively in the child’s care, in accordance with the child’s relevant plans. Seek to develop and maintain effective personal relationships with such persons, bodies or organisations as the registered person considers appropriate having regard to the range of needs of children for whom it is intended that the children’s home is to provide care and accommodation. (Regulation 5 (a) (d)) 25/10/2017

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Requirement Due date

The quality and purpose of care standard is that children receive care from staff who understand the children’s home’s overall aims and outcomes it seeks to achieve for the children. In particular, ensure that staff protect and promote each child’s welfare. (Regulation 6 (1)) 25/10/2017

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Requirement Due date

The registered person must ensure that staff understand and apply the home’s statement of purpose, promote and protect each child’s welfare, provide personalised care that meets each child’s needs, as recorded in the child’s relevant plans, taking account of the child’s background and help each child to develop resilience and skills that prepare the child to return home, to live in a new placement or to live independently as an adult. (Regulation 6 (2) (i) (ii) (iv) (vi)) 25/10/2017

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Requirement Due date

The children’s views, wishes and feelings standard is that children receive care from staff who develop a positive relationship with them, engage with them and take their views, wishes and feelings into account in relation to matters affecting the children’s care and their welfare and their lives. (Regulation 7 (a) (b) (c)) 25/10/2017

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Requirement Due date

The registered person must help each child to achieve the child’s educational and training targets, as recorded in the child’s relevant plans, and help a child who is excluded from school, or who is of compulsory school age but not attending 25/10/2017 Inspection report children’s home: 1256365 5 school, to access educational and training support throughout the period of exclusion or non-attendance and to return to school as soon as possible. (Regulation (8) (i) (viii)) The enjoyment and achievement standard is that children take part in and benefit from a variety of activities that meet their needs and develop and reflect their creative, cultural, intellectual, physical and social interests and skills. Young people should be encouraged to participate in activities that they enjoy and which meets and expands the child’s interests and preferences. (Regulation 9 (1) (2) (ii)) 25/10/2017

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Requirement Due date

The health and well-being standard is that children receive advice, services and support in relation to their health and well- being and are helped to achieve and lead healthy lifestyles. (Regulation 10 (1) (b) (c)) 25/10/2017

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Requirement Due date

The positive relationships standard is that children are helped to develop, and benefit, from relationships based on mutual respect and trust, an understanding about acceptable behaviour and positive responses to other children and adults. In particular, the standard requires that the registered person ensures that staff meet each child’s behavioural and emotional needs, as set out in the child’s relevant plans, and strives to gain each child’s respect and trust. (Regulation 11 (1) (a) (b) (c) (2) (i) (viii)) 25/10/2017

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Requirement Due date

* The protection of children standard is that children are protected from harm and enabled to keep themselves safe. The registered person must 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; have the skills to identify and act upon signs that a child is at risk of harm; manage relationships between children to prevent them from harming each other; and take effective action whenever there is a serious concern about a child’s welfare. Staff must be familiar with, and act in accordance with, the home’s child protection policies and ensure that the home’s day-to-day care is arranged and delivered so as to keep the child safe and to protect each child effectively from harm. Child protection policies must be monitored regularly. (Regulation 12 (1) (2) (a) (i) (iii) (iv) (vi)

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Requirement Due date

*The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that promotes their welfare, and that there are sufficient staff who have the experience, qualifications and skills to meet the needs of each young person. (Regulation 13 (1) (b) (c) (d)) 03/11/2017 Inspection report children’s home: 1256365 6 The care planning standard is that children receive effectively planned care in or through the children’s home. (Regulation 14 (1) (a)) 25/10/2017

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Requirement Due date

The registered person must ensure that the home is at all times conducted in a manner which is consistent with its statement of purpose. (Regulation 16 (5)) 25/10/2017

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Requirement Due date

The registered provider must appoint a person to manage the children’s home. (Regulation 27 (a)) 25/10/2017

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Requirement Due date

The registered person must ensure that the employment of any person on a temporary basis at the children’s home does not prevent children from receiving such continuity of care as is reasonable to meet their needs. (Regulation 31 (1)) 25/10/2017

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Requirement Due date

The registered person must ensure that each employee completes an appropriate induction. (Regulation 33 (a)) 25/10/2017

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Requirement Due date

The registered person must revise and implement a policy which sets out how appropriate behaviour is to be promoted in the children’s home and the measures of control, discipline and restraint which may be used in relation to the children’s home are reviewed regularly. Regulation 35 (a) (b)) 25/10/2017

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Requirement Due date

The registered person must ensure that records are kept of any allegation of abuse or neglect, and the action taken in response, and describe the measures which may be necessary to protect children following an allegation of abuse or neglect. (Regulation 34 (d) (e)) 25/10/2017

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Requirement Due date

The registered person must detail the steps to be taken to prevent children from being absent without permission. (Regulation 34 (4) (a)) 25/10/2017

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Requirement Due date

The registered person must maintain records for each child which are kept up to date and signed and dated by the author of each entry. (Regulation 36 (1) (a) (b)) 25/10/2017

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Requirement Due date

Schedule four sets out the other information that the registered person must keep in relation to the children’s home. The registered person must maintain in the home the records in schedule four with particular regard to the change of staff. (Regulation 37 (1) (2) (a)) 25/10/2017

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Requirement Due date

The registered person must ensure that a record is made of any complaint, the action taken in response and the outcome of any investigation. (Regulation 39 (3)) 25/10/2017

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Requirement Due date

The registered person must notify Ofsted under Regulation 40 if there is an incident relating to the child which the registered person considers to be serious. (Regulation 40 (4) (e)) 25/10/2017

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Requirement Due date

In order to complete a quality of care review the registered 25/10/2017 Inspection report children’s home: 1256365 7 person must establish and maintain a system for monitoring, reviewing and evaluating the quality of care provided for children and the feedback and opinion of children about the children’s home, its facilities and the quality of care they receive in it. (Regulation 45 (2) (a) (b))

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Requirement Due date

* These requirements are subject to a compliance notice.

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Recommendations

 Children’s home’s staff should take every step to ensure that individual children and young people are not subject to discrimination or bullying from their peers with particular regard to their sexuality. (‘Guide to the children’s homes regulations including the quality standards’, page 16, paragraph 3.12)  Positive relationships are those which are characterised by consistency and unconditional positive regard for the child on the part of the carer and where the carer acknowledges the importance of understanding and responding to the child’s lived experience of care. Positive, stable relationships help the child to feel secure and cared for. (‘Guide to the children’s homes regulations including the quality standards’, page 21, paragraph 4.3)  The capacity and competence of staff to build constructive, warm relationships with children and young people that actively promote positive behaviour, provides

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Recommendations

the foundations for managing any negative behaviour. (‘Guide to the children’s homes regulations including the quality standards’, page 39, paragraph 8.14)  Children must feel safe and be safe. Staff should support children to be aware of and manage their own safety both inside and outside the home to the extent any good parent would. Staff should help young people to understand how to protect themselves, feel protected and protected from significant harm. (‘Guide to the children’s homes regulations including the quality standards’, page 43, paragraph 9.9)  Staff skills for safeguarding should include being able to identify signs that a child may be at risk, and support the young people with strategies to manage and reduce any risks. (‘Guide to the children’s homes regulations including the quality standards’, page 43, paragraph 9.10)  Where there is a possibility that a young person will run away or go missing from

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Recommendations

a children’s home placement, their placement plan should include a strategy to minimise this risk. (‘Guide to the children’s homes regulations including the quality standards’, page 45, paragraph 9.24)  The registered person is responsible for ensuring that all their staff have been adequately trained in the principles of restraint and any restraint techniques appropriate to the needs of the children the home is set up to care for as defined in the home’s statement of purpose. (‘Guide to the children’s homes regulations including the quality standards’, page 49, paragraph 9.57)  The registered person is responsible for maintaining good employment practice. Inspection report children’s home: 1256365 8 They must ensure that recruitment, induction, supervision and performance management of staff safeguards children and minimises potential risks to them. (‘Guide to the children’s homes regulations including the quality standards’, page

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Recommendations

61, paragraph 13.1)  Children’s case records must be kept up to date and signed and dated by the author of each entry. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.3)

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Overall experiences and progress of children and young people: inadequate

The home was taken over by a different provider on 1 July 2017. Transition arrangements for this takeover were significantly flawed. For example, consultation with young people did not take place and young people were not offered the opportunity to meet and get to know their new staff before the takeover commenced. Consequently, young people’s anxieties are significantly heightened due to the loss of a staff team that they had formed close trusting relationships with. Residential care plans are inadequate. Plans are not updated or reviewed and are not known by the staff employed to work in the home. For example, one staff member was asked about the long-term aims for one young person and replied, ‘I don’t know, I am just covering at the moment.’ There are many different staff from different homes covering the staff shortage. Consequently, young people’s care planning drifts because staff fail to familiarise themselves with young people’s individual aims. This means that

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Overall experiences and progress of children and young people: inadequate

young people are not guided or supported in order to achieve their placement goals. Since the home has been taken over, there has been a significant decline in young people’s educational attendance with one young person’s attendance dropping from 92% to 34%. Staff do not consistently promote the importance of education. For example, one young person gained a placement on a chef’s course. However, staff did not ensure that he had the equipment and uniform required in order to commence the course. Consequently, the young person lost his place on the course. Young people are not motivated to attend school and their lack of attendance is not challenged by any suitable strategy or consequence. This culture of non-attendance promotes a lack of importance within education, which ultimately has a significant impact on young people’s future life chances. Young people who previously enjoyed recreational activities such as go-karting and off-

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Overall experiences and progress of children and young people: inadequate

road cycling, no longer take part. Staff attempt to introduce new activities. However, this is persistently declined by young people. The failure to develop trusting relationships between staff and young people results in a significant lack of engagement. Consequently, young people spend a considerable amount of time away from the home engaging in risk-taking behaviours within the community. Consultation with young people is inadequate. Young people were not suitably consulted about the changes to the running and management of the home. Young people have endured a high turnover of staff and inconsistent management, resulting in a lack of trusting relationships between young people and staff. Young people rebel on a regular Inspection report children’s home: 1256365 9 basis as a result of inconsistent staffing. Young people say, ‘Staff don’t want to be here. They don’t like us. They come here but can’t wait to go home.’

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Overall experiences and progress of children and young people: inadequate

Young people know how to complain and have made seven complaints since the home was taken over on 1 July 2017. For example, some complaints refer to the transition process of the new provider, injury during a restraint and bullying. None of the complaints have been suitably investigated and young people are not provided with an adequate outcome. A senior staff member said, ‘Some of the staff referred to in the complaints have resigned or gone off sick, so the issue can’t be dealt with.’ Consequently, although young people raise concerns, leaders and managers fail to follow the home’s complaints procedure and do not ensure that a suitable outcome is reached in order to safeguard and protect young people. Healthcare plans are not updated or reviewed. Young people who require controlled medication do not have this reviewed quickly when there is a concern regarding its effectiveness. Likewise, although the home has made referrals to external agencies with

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Overall experiences and progress of children and young people: inadequate

regard to substance misuse, young people view this as more strangers in their home and refuse to engage. One young person said, ‘I am sick of strangers coming in and out of my home. I don’t know who they are. I get up some days and don’t know anyone. I don’t want to talk to any more staff.’ Plans in place to reduce substance misuse are deficient. Inconsistent staff and a failure to communicate safety plans for young people places their health and well-being at risk. For example, young people who are to be supervised with finances are provided with money in their hand. Young people use this money to purchase cannabis and also class A substances. This has resulted in them requiring emergency medical evaluation. Communication with parents and social workers is inadequate. A parent said, ‘I hardly ever receive any information about my child. I have been told he has been missing on two occasions, but I now understand it to be more than 50.’ Another parent said, ‘My

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Overall experiences and progress of children and young people: inadequate

son has declined in all areas. He isn’t at school, he looks unkempt and his behaviour and attitude have changed for the worse.’ A social worker said, ‘I have escalated concerns to senior management. I am not happy how the home is being run.’ Due to the significant changes in the staff working at the home, relationships between parents and social workers are not formed. There is little emphasis on developing these relationships or including parents and social workers in the development and review of the plans in place within the home.

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

Young people’s risk assessments are not updated or reviewed. This means that presenting risk-taking behaviours are not identified or agreed strategies put into place to reduce the risks to young people. Likewise, where informal strategies are agreed between staff, these are not communicated to other staff members. This means that young people’s risks are not managed consistently or effectively, including substance misuse and episodes of going missing. Not all staff receive appropriate de-escalation and physical intervention training in order to defuse and manage challenging situations. This has resulted in young people being restrained by staff who do not have the skills or experience to do so. Likewise, young Inspection report children’s home: 1256365 10 people are restrained by staff they do not know or have not formed a trusting relationship with. On most occasions, this has resulted in the situation being managed

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

inappropriately with young people’s behaviour escalating and the police being contacted. Consequently, young people are at risk of becoming criminalised or harmed as a result of inconsistent and untrained staff. Behaviour management systems are deficient. Plans and strategies to manage challenging behaviour are not updated or reviewed and are not known by staff. Unacceptable behaviour is not consistently challenged and therefore there is a culture of young people swearing, shouting and breaking things around the home on a regular basis. A young person said, ‘We can do what we want. Staff don’t do anything. They don’t care. They know we are not going to stop so they don’t say anything.’ Records of sanctions are unclear with some being incomplete. Sanctions are not relevant to the behaviours exhibited. For example, young people will not be given a lift in the car the next day if they use homophobic or racist language to staff or other young people. A

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

staff member said, ‘Young people always want a lift so we use this because it may work.’ This does not address the derogatory comments or young people’s beliefs which have a negative impact on others or how this attitude may serve to hinder their progress and future life aims. Consequently, staff do not have the skills or experience necessary to manage challenging behaviour to enable young people to make positive and lasting change. Incidents of young people being reported as missing from the home have significantly increased, with 58 instances since the home was taken over on 1 July 2017. While staff take appropriate reporting action, there is little evidence of staff searching for and locating missing young people. Staff say, ‘We don’t really know the young people that well so we don’t really know where to look for them.’ On occasions, young people return to the home via bedroom windows without staff knowledge. On two occasions, a young

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

person has been found in the home by police conducting a room search as part of their missing from home investigations. A young person said, ‘Staff prefer it when he isn’t here because he damages the house. We prefer it too.’ The failure of staff to develop trusting relationships with young people results in young people disengaging with the service and frequently absenting themselves from the home. Young people have reported incidents of being bullied in the home. Homophobic and racist comments are regularly used towards peers and staff members. Furthermore, one young person is regularly placed in a headlock by his peer, while another has received bruises to his face. While records are held, there is no recorded information of how these matters are managed. A staff member said, ‘It’s just banter. They complain and then they are friends again and don’t want to take it further.’ A parent said, ‘My son had

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

bruises to his face and staff were not aware of it. I haven’t had any communication about what has happened to sort this out.’ As a result, young people are not protected within their home. Behaviour which is derogatory or physically harmful is not suitably challenged. Failure to develop suitable strategies, such as a detailed risk management plan, means that this behaviour continues to be problematic within the home. Young people’s safety, well-being and privacy are compromised within the home. Young people living in the community frequently access the home via bedroom windows. These young people stay overnight in the home and on occasions are joined by all other residents in one bedroom. This has resulted in one allegation of sexual activity between Inspection report children’s home: 1256365 11 residents and several allegations between one resident and a young person entering the home. While staff, once aware of the situation, take appropriate action to ensure that

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

the property is secure and levels of monitoring and supervision increase, the level of sexual activity disclosed by young people in a recent incident was not notified to the statutory agencies or Ofsted in a timely manner to help keep young people safe. Although some repairs have taken place, young people persistently break window restrictors and door sensors resulting in the continued entry of young people to the home. A young person said, ‘Staff know that X is in the house. They just don’t say anything because they don’t want the hassle.’ Consequently, staff fail to provide a safe and secure environment for young people to live in. The health and safety of young people living in the home and staff working in the home is compromised. This is because staff fail to comply with fire safety procedures. For example, on two occasions, young people who were not being appropriately supervised by staff removed a sofa from the home. They set this on fire. When staff were made

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

aware both young people and staff attempted to extinguish the fire before contacting the fire services. Furthermore, there is no evidence of staff working with young people about the consequences of their actions. A young person said, ‘They don’t care and we don’t care. If we don’t like it, we will burn it.’ There is a consistent failure of staff to recognise the decline in young people’s behaviour and to take suitable action. Likewise, the failure to adhere to the fire procedures in place highlights the significant lack of experience, knowledge and skills of those employed to work in the home.

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The effectiveness of leaders and managers: inadequate

The home was taken over by a new provider on 1 July 2017. A new registered manager and a new staff team commenced employment on this date. Young people were not consulted about the changes to the running of the home and had not been given the opportunity to meet with the new staff who would be working with them. Since 1 July 2017, there has been a significant change in the running of the home. The new registered manager and staff team have resigned. A temporary acting manager who was deployed from another of the organisation’s homes is on sick leave. There are four new and inexperienced staff recently employed. The remaining staff now working in the home have been redeployed from other homes to make up the deficit in the team. Furthermore, due to the level of disruption in the home, a number of agency staff are also employed within the home. As a result, the home is currently run without a registered manager or dedicated, permanent and skilled staff team.

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The effectiveness of leaders and managers: inadequate

New staff who have commenced employment in the home have not undertaken appropriate training or induction. This means that they have not yet acquired the skills to work with the young people or have had the opportunity to understand the policies and procedures that will guide their work. Staff working in the home do not receive consistent supervision. They are not supported and guided within their work or provided with a critical analysis of their progress. This means that the young people are being cared for by staff who are unclear on their roles and responsibilities towards the young people they look after. Internal monitoring of how the home operates, the care provided to young people and Inspection report children’s home: 1256365 12 the progress towards outcomes is not undertaken. Consequently, poor practice is not consistently identified or managed within the home. External monitoring of the home is conducted. Reports highlight deficits in practice and

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The effectiveness of leaders and managers: inadequate

concerns relating to staffing, young people’s behaviour and consistency. However, there is no evidence of how these matters are addressed by the home’s manager. More recently, the registered individual has devised an action plan to tackle some of the concerns arising from the home. However, in light of the fact that the home does not have a dedicated registered manager or staff team and the relationships between the current staff and young people remain fractured it is unclear how these changes can be implemented. Notifiable events in accordance with Regulation 40 are not routinely forwarded to Ofsted for review. Failure to share this information with the regulatory body means that actions taken in the event of a serious incident cannot be evaluated for their effectiveness in order that young people remain safe inside and outside the home. The home is not working in accordance with its dedicated statement of purpose. Young

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The effectiveness of leaders and managers: inadequate

people are not cared for by a permanent registered manager or staff team. Staff are not consistently inducted, trained or supervised in their roles within the home. Consequently, staff do not have the skills and knowledge required to offer consistent planned and effective care to young people. As a result of this inspection, two compliance notices have been issued to effect immediate change in the areas of the protection of children and the leadership and management in the home. In addition, 23 requirements and nine recommendations are also made to improve practice.

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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: 1256365 13

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Children’s home details

Registered provider: Bettercare Keys Limited

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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

Maria McGranaghan: social care inspector Inspection report children’s home: 1256365 14 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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