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

Inspection report children’s home: 1248043 1 Registered provider: Bettercare Keys Ltd

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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 providing care and accommodation for up to two young people who have learning disabilities.

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Information about this children’s home

Inspection dates: 14 to 15 November 2017

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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 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: 25 January 2017

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good

Overall judgement at last inspection: sustained effectiveness

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Enforcement action since last inspection:

None Inspection report children’s home: 1248043 2

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Key findings from this inspection

 Young people are safe and feel safe because staff have a very good understanding of their individual needs.  Young people who have complex needs are able to develop positive and resilient relationships with a caring, stable staff team.  Young people stay in a welcoming and supportive home where they are fully valued and respected. A strong feature of the home is the existence of the warm and affectionate relationships between staff and young people.  Young people are supported to make very good progress in education and in health issues.  Staff are highly effective in managing young people’s complex and challenging behaviour. They are consistent in their response to negative behaviour and have been successful in their efforts to help young people manage their frustrations and anxieties, which are often brought about by their disabilities.  Staff ensure that children and young people are given every opportunity to

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Key findings from this inspection

experience activities that may not otherwise be available to them. They are extremely dedicated to their role and show great commitment to ensuring that vulnerable children and young people are enabled to live life to the full.  Independent advocates are available and young people feel fully included in all decisions about their lives.  The manager and staff have made very good links with a variety of professionals. These professionals speak highly of the home and the progress that some young people have made. The children’s home’s areas for development:

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Key findings from this inspection

 Recording of physical interventions needs to be more robust.  Repairs within the home need to be carried out in a timely manner.  Visitors to the home are not routinely vetted.  Staff require training in order to meet the individual needs of young people, especially training related to self-harming behaviour.  Staff, including probationary staff, need to receive supervision as set out in the provider’s policies and procedures

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Inspection date Inspection type Inspection judgement

25/01/2017 Interim Sustained effectiveness Inspection report children’s home: 1248043 3

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Statutory requirements

This section sets out the actions that the registered person(s) must take to meet the Care Standards Act 2000, Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. The registered person(s) must comply within the given timescales.

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Requirement Due date

The protection of children standard is that children are protected from harm and enabled to keep themselves safe.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure—

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Requirement Due date

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;

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Requirement Due date

that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm;

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Requirement Due date

that the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health; (Regulation 12(1)(2)(a)(i)(b)(d))

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Requirement Due date

In particular, ensure that all visitors to the home are suitably vetted and signed in and that all maintenance within the home is carried out in a timely manner. 18/01/2018

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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 helps children aspire to fulfil their potential; and promotes their welfare. In particular, the standard in paragraph (1) requires the registered person to— have the experience, qualifications and skills to meet the needs of each child. (Regulation 13(2)(c))

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Requirement Due date

In particular, ensure that the staff are trained in areas that enable them to meet the individual needs of young people, such 18/01/2018 Inspection report children’s home: 1248043 4 as those who self-harm.

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Requirement Due date

The registered person must ensure that all employees receive practice-related supervision. (Regulation 33(4)(b))

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Requirement Due date

In particular ensuring that probationary staff working within the home receive supervision. 18/01/2018

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Requirement Due date

The registered person must prepare and implement a policy (‘the behaviour management policy’) which sets out the measures of control, discipline and restraint, which may be used in relation to children in the home. The registered person must ensure that within 24 hours of the use of a measure of control, discipline or restraint in relation to a child in the home, a record is made which includes—

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Requirement Due date

a description of the measure and its duration; and the name of the person who used the measure (‘the user’), and of any other person present when the measure was used. (Regulation 35(1)(b)(2)(vi))

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Requirement Due date

In particular, that a robust written description is kept for all physical interventions. 18/01/2018

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Recommendations

 Ensure that staff play a full role in preparing a journal for young people which captures their journey through care and provides children and young people a lasting memory. (‘Guide to the children’s homes regulations including the quality standards’, page 16, paragraph 3.14)

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Overall experiences and progress of children and young people: good

Young people make good progress because staff show them affection and attention. Staff were observed greeting young people, who were returning from school, with a spontaneous offer of a hug and spent time enquiring about their day. A young person said, ‘I love the staff they are great.’ A social worker commented, ‘The staff have a really good bond with him; this has led to him having a real sense of stability in his life.’ This level of emotional support means that the young people feel valued and cared for, and it enables them to develop a sense of belonging.

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Overall experiences and progress of children and young people: good

Young people show warmth and affection for the staff. Their demeanour indicates that they feel safe and are able to approach the staff with any concerns or anxieties. There is a relaxed atmosphere within the home, with plenty of chatter and laughter. This not only Inspection report children’s home: 1248043 5 further enhances young people’s self-esteem, but also recognises important milestones in each young person’s life that are shared with parents and fellow professionals. A social worker commented, ‘I think the connections and relationships that staff have formed with the young people are fantastic and have significantly helped in reducing their anxieties.

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Overall experiences and progress of children and young people: good

Staff diligently keep to routines for the day. This helps young people to have good routines for sleeping and keeping good school attendance. This gives young people a sense of order to each day, so that they know what to expect and this reduces their anxieties. Consequently, young people engage well with planned activities and all young people have high attendance levels at school.

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Overall experiences and progress of children and young people: good

Staff continue to use a range of methods to ensure that young people have a voice and remain at the centre of their plans. As well as using suitable communication aids, such as pictures, symbols and simple sign language, staff are receptive to young people’s changing needs through their non-verbal clues, such as their body language. This ensures that staff can respond to young people appropriately, especially during times of heightened anxiety. Young people are encouraged to state their wishes and preferences in individual key-working sessions. These are then used as resources by staff members, who incorporate these ideas into planning of activities, celebration events and menus.

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Overall experiences and progress of children and young people: good

Young people have advocates. This facilitates communication, and helps young people to share their ideas and make known their opinions. A social worker said, ‘I am delighted that on the last couple of reviews he has been able to come into the meeting and talk to us without any signs of being anxious. That is a credit to the staff’s hard work and his confidence growing.’

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Overall experiences and progress of children and young people: good

Staff understand the needs of the young people. They are enthusiastic about their work and committed to providing an inclusive service to overcome the difficulties associated with additional needs and disability. For example, young people have enjoyed numerous holidays with staff, which they help plan by choosing locations and day-to-day activities to enjoy while on holiday. A young person commented, ‘I love my holidays and I have made friends there.’ The staff capture these moments with photographs. However, this could be taken a step further by utilising the photographs to make a journal for young people, as a lasting memory of their time spent at the home.

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Overall experiences and progress of children and young people: good

Staff have registered young people with a range of external services, such as GPs, opticians and dentists. They proactively liaise with external colleagues to review each young person’s physical health and matters relating to their well-being. Recorded health plans help the team to keep up to date with individual young people’s current issues. This prioritises their unique needs and results in them making significant progress in meeting developmental milestones, for example in self-care. Social workers commented, ‘The improvement has been immense, especially in self-care,’ and, ‘It is fantastic to see milestones being reached in self-care.’

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Overall experiences and progress of children and young people: good

The young people are encouraged and supported in developing their independence skills in line with their care plan, age and understanding. Young people have plans to manage Inspection report children’s home: 1248043 6 their own day-to-day self-care needs and are supported to have an understanding of the value of money by paying for goods in shops and waiting to receive change. They also have practical support from staff in areas such as bringing their own laundry from their rooms and placing it in the washing machine. Staff understand that transitions towards independence for the young people are very difficult, and if young people are struggling with, for example, tidying their rooms or budgeting, staff amend their plans accordingly. This means that young people can move towards independence at a pace that alleviates any anxieties they may have and they are able to talk to staff about why they find it

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Overall experiences and progress of children and young people: good

The home presents as a lived-in family home. It is warm, welcoming and comfortable. The quality of furniture and decoration is very good. However, maintenance within the home is not carried out in a timely manner. For example, ceiling lights in a young person’s bedroom were not working. The manager had reported this to the provider over two months ago; however, at the time of the inspection the repairs had not been carried out.

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

Young people say that they feel safe at the home and that they can identify someone whom they can talk to. Placing authority social workers said that they are confident in the staff team’s ability to keep young people safe.

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

Staff maintain a safe environment by being vigilant at all times. There are no concerns regarding young people going missing from care. The risk of going missing is minimised by the level of staff and their one-to-one supervision of young people. Each young person has a personal emergency evacuation plan that is individual to their needs.

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

Young people continue to benefit from robust risk assessments. Plans are individualised, detailed and identify all aspects of risk. They outline intervention strategies to ensure that young people are protected. Staff are knowledgeable about young people’s particular vulnerabilities, which enables them to predict risk and take quick action to reduce harm. They have a strong awareness of how to safeguard young people, using the home’s own procedures and working in partnership with all child protection professionals. Staff respond immediately to any safeguarding concerns and inform all professionals of necessary details.

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

The behaviour management techniques that staff use are very effective. Staff know the young people extremely well and use helpful diversionary techniques if they are becoming agitated or anxious. Staff use strategies that are individual to the young people and engage them in positive activities of their choice. A real strength of the care provided is the way in which staff express clear and consistent boundaries for young people. Staff members take time to explain that the need for such boundaries is to prevent harm to staff or young people. As a result, behaviour is managed well, with incidents of the use of physical intervention reducing, significantly so for one young person. When it is used, it is as a last resort and only when it is considered that a young person or others may be in danger. Most interventions are low level and are used to Inspection report children’s home: 1248043 7 defuse a situation before it reaches crisis point. However, the recording of physical

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

interventions needs to be made clearer and more meaningful for review. For example, despite staff indicating on the form which holds were used by ticking the appropriate boxes, this is not clear in the narrative. This makes it difficult to review what took place and thereby reduces the opportunity to utilise the information to reduce the likelihood of recurrence.

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

Medication, including periodic and emergency medication, is well managed and suitably administered. Written protocols and consents are in place, and staff receive regular refresher training. Staff are clear about expectations to ensure that young people receive their medication safely.

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

Health and safety processes are robust. Each young person has a detailed individual risk assessment that staff understand. As a result, the home is able to take all necessary steps to reduce the likelihood of young people being at risk of harm. Environmental risk assessments accurately reflect identified risks and potential hazards. Young people and staff understand fire safety systems and how to respond if emergencies occur. The safety of young people is promoted further through good environmental health and food safety processes.

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

Careful recruitment of staff helps to safeguard young people. Effective procedures and clear lines of accountability are followed, ensuring that only suitable adults work in the home. However, visitors to the home are not routinely asked to sign in. This potentially could place young people at risk of harm and does not allow the manager to have an overview of who visitors are and when visitors are in the home.

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The effectiveness of leaders and managers: good

The registered manager provides strong leadership. She is appropriately experienced and qualified. She has an inclusive, open management style, which staff value and reflect in their practice with young people. Staff described their manager as ‘approachable’, ‘knowledgeable’, and ‘very supportive’.

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The effectiveness of leaders and managers: good

Team meetings take place regularly. This allows the staff team to discuss the running of the home and to look at ways to improve the service they offer. Staff also use this time to reflect on young people’s progress and to decide how best to support young people to reduce risks, such as self-harming behaviours. Staffing levels are good and rotas clearly show the management arrangements that are in place on a daily basis. The staff team members speak positively of the support that they receive from management at the home. However, the inspection identified that formal supervision has not taken place at regular intervals for staff who are in their probationary period. This does not provide sufficient opportunities to review whether, or how, staff are contributing to young people achieving improved outcomes.

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The effectiveness of leaders and managers: good

All mandatory training has been completed. However, some staff have not received training in all areas that are required to meet the specific needs of young people, such as training related to self-harming behaviour. This lack of training means that not all Inspection report children’s home: 1248043 8 staff are able to meet the known or emerging behaviours of the young people living in the home.

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The effectiveness of leaders and managers: good

The manager and staff are proud of the progress young people have made since moving into the home. They demonstrate a commitment to making further improvement in the lives of the young people who live in the home. They take pride in the young people’s achievements and celebrate difference. A staff member commented, ‘I am so proud of them both, even little steps mean so much; they are both doing so well.

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The effectiveness of leaders and managers: good

Managers are proactive in their efforts to maintain strong links with partner agencies, including local authorities, education professionals and healthcare providers. Such agencies report that the home works with them to ensure that young people’s needs, risks and vulnerabilities are safely and caringly met. A social worker commented, ‘The communication between myself and the home is second to none. I receive very comprehensive monthly reports and I am updated on all significant incidents.’

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The effectiveness of leaders and managers: good

The home has effective monitoring systems in place. The manager continues to monitor and review areas for development and the young people’s progress. Regulation 44 and 45 reports and the recently reviewed statement of purpose are submitted in a timely manner and provide a very good level of detail and analysis. The manager uses a range of templates and tools to review patterns and trends related to the young people’s progress effectively.

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The effectiveness of leaders and managers: good

The home has appropriate systems in place to notify Ofsted and other relevant bodies of significant events that occur within the home or with young people. This ensures that those with an interest in young people’s welfare are kept appropriately informed.

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The effectiveness of leaders and managers: good

Although some requirements and recommendations have been set at this inspection, these do not significantly undermine the good-quality individualised care that the young people receive.

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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 Inspection report children’s home: 1248043 9 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: 1248043 10

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Children’s home details

Registered provider: Bettercare Keys Ltd

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Children’s home details

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

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Children’s home details

Responsible individual: Melanie McGuinness

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Inspector

Elaine Allison, social care inspector Inspection report children’s home: 1248043 11 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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Inspector

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Inspector

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