Children's home run by Keys Child Care Limited in Telford and Wrekin

Inspection report children‟s home: SC449245 1 SC449245 Registered provider: Bryn Melyn Care

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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 is registered to accommodate up to three young people who have emotional and/or behavioural difficulties. The service is owned by a private company.

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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 are not protected and their welfare is not promoted or safeguarded. The care and experiences of children are poor and they are not making progress.

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inadequate

Date of last inspection: 13 February 2017

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inadequate

Overall judgement at last inspection: improved effectiveness

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inadequate

Enforcement action since last inspection: none Inspection report children‟s home: SC449245 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

 Staff do not have the skills or training to meet children‟s needs, or keep them safe.  Risks are not identified. Risk assessments, plans and strategies are not up to date and do not safeguard children or staff.  Staff do not address children‟s needs or behaviour, including sexualised behaviour towards staff and peers.  Staff fail to meet children‟s health needs.  Staff do not handle, administer or record children‟s medication in line with the prescriber‟s advice or the organisation‟s medication policy.  The standard of accommodation is poor. The home is uncared for and unwelcoming. Furniture is damaged.  Management of the home has been ineffective.  Staff do not receive sufficient support from managers.  Children are not being supported by good partnership work with placing authorities.  Children‟s records lack key information.  Records of restraints and consequences are not accurate.  The home‟s statement of purpose does not provide accurate, up-to-date

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Key findings from this inspection

 A new experienced manager has recently been appointed. The responsible individual is supporting her to develop an action plan. She has already started to make some early improvements.

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Inspection date Inspection type Inspection judgement

13/02/2017 Interim Improved effectiveness 12/09/2016 Full Good 11/02/2016 Interim Sustained effectiveness 27/07/2015 Full Good Inspection report children‟s home: SC449245 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

In meeting the quality standards, the registered person must ensure that staff seek to involve each child‟s placing authority in the child‟s care, in accordance with the child‟s relevant plans. (Regulation 5(a)) 28/02/2018

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Requirement Due date

The positive relationships standard is that children are helped to develop, and to 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 in paragraph (1) requires the registered person to ensure that staff meet each child‟s behavioural and emotional needs, as set out in the child‟s relevant plans; help each child to develop socially aware behaviour; encourage each child to take responsibility for the child‟s behaviour in accordance with the child‟s age and understanding; communicate to each child expectations about the child‟s behaviour and ensure that the child understands those expectations in accordance with the child‟s age and understanding; help each child to understand, in a way that is appropriate according to the child‟s age and understanding, personal, sexual and social relationships, and how those

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Requirement Due date

relationships can be supportive and harmful; understand how children‟s previous experiences and present emotions can be communicated through behaviour and have competence and skills to interpret these and develop positive relationships with children; are provided with supervision and support to enable them to understand and manage their own feelings and responses to the behaviour and emotions of children, and to help children to do the same; de-escalated confrontations with or between children, or potentially violent behaviour by children and that each child is encouraged to build and maintain positive relationships with others. (Regulation 11(1) and (2)(a)(i)(ii)(iii)(v)(vi)(ix)(x)(xi)(b)) 28/02/2018

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Requirement Due date

The health and well-being standard is that the health and well- being needs of children are met; children receive advice, services and support in relation to their health and well-being; 28/02/2018 Inspection report children‟s home: SC449245 4 and children are helped to lead healthy lifestyles. (Regulation 10(1)(a)(b)(c)) The protection of children standard is that children are protected from harm and enabled to keep themselves safe. In particular, the standard in paragraph (1) requires the registered person to ensure: that staff assess whether each child is at risk of harm, taking into account information in the child‟s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child; 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; take effective action whenever there is a

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Requirement Due date

serious concern about a child‟s welfare and 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) and (2)(a)(i)(iii)(iv)(vi)(d)) 28/02/2018

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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 lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home‟s statement of purpose; to ensure that staff have the experience, qualifications and skills to meet the needs of each child; ensure that the home‟s workforce provides continuity of care to each child and 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 and use monitoring and review systems to make continuous improvements in the quality of care provided

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Requirement Due date

in the home. (Regulation 13(1)(a)(b) and (2)(a)(c)(e)(f)(h)) 28/02/2018

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Requirement Due date

The registered person must keep the statement of purpose under review and, where appropriate, revise it; and notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision. (Regulation 16(3)(a)(b)) 28/02/2018

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Requirement Due date

The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children‟s home. (Regulation 23(1)) 28/02/2018

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Requirement Due date

If the Regulatory Reform (Fire Safety) Order 2005(a) applies to the home the registered person must ensure that the requirements of that Order and any regulations made under it, except for article 23 (duties of employees), are complied with in 28/02/2018 Inspection report children‟s home: SC449245 5 respect of the home. (Regulation 25(2)(b)) This specifically relates to staff completing fire awareness training. The responsible individual must have the capacity, experience and skills to supervise the management of the home, or the homes, in respect of which the responsible individual is nominated. (Regulation 26(7)(b)) 28/02/2018

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Requirement Due date

A person may only manage a children‟s home if having regard to the size of the home, its statement of purpose, and number and needs (including any needs arising from disability) of the children, the person has the appropriate experience, qualification and skills to manage the home effectively and lead the care of children. (Regulation 28(1)(b)(i)) 28/02/2018

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Requirement Due date

The registered person must ensure that all employees undertake appropriate continuing professional development; receive practice-related supervision by a person with appropriate experience; and have their performance and fitness to perform their roles appraised at least once every year. (Regulation 33(4)(a)(b)(c)) 28/02/2018

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Requirement Due date

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 the name of the child; details of the child‟s behaviour leading to the use of the measure; the date, time and location of the use of the measure; a description of the measure and its duration; details of any methods used or steps taken to avoid the need to use the measure; the name of the person who used the measure (“the user”), and of any other person present when the measure was used; the effectiveness and any consequences of the use of the measure; and a description of any injury to the child or any other person, and any medical treatment administered, as a result of the measure; within 48 hours of the use of the measure, the registered person, or a person who is authorised by the registered person to do so (“the authorised person”) has

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Requirement Due date

spoken to the user about the measure; and has signed the record to confirm it is accurate; and within 5 days of the use of the measure, the registered person or the authorised person adds to the record confirmation that they have spoken to the child about the measure. (Regulation 35(3)(a)(b)(c)) 28/02/2018

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Requirement Due date

The registered person must maintain records („case records‟) for each child which: include the information and documents listed in Schedule 3 in relation to each child; are kept up to date; and are signed and dated by the author of each entry. (Regulation 36(1)(a)(b)(c)) 28/02/2018 Inspection report children‟s home: SC449245 6

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Overall experiences and progress of children and young people: inadequate

A lack of management oversight and support to the staff team has resulted in children‟s needs not being met. Staff have failed to keep children safe or ensure their well-being. Staff struggle to form positive, influential relationships with children. Children are more influenced by each other than the staff team. As a result, children learn unsafe behaviours instigated by their peers. These behaviours place children and staff at serious risk of harm. They damage children and the relationships that they have with each other and with staff. There are no clear strategies to help children improve their health. Staff are not adequately informed of children‟s medical histories including vaccinations. Staff are unable to positively influence and change poor lifestyle choices. For example, staff successfully supported a child to attend a doctor‟s appointment in August 2017 for a persistent health concern. Cream was prescribed, but staff did not apply this regularly.

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Overall experiences and progress of children and young people: inadequate

The cream is not stored in the medication cabinet and is not currently being administered at all. The child is still suffering from the same health complaint, which is not being treated. Staff do not work in partnership with children‟s placing authorities. Care plans, education healthcare plans and minutes of review meetings are not available to staff or children. Staff write placement plans for children, but these lack key information. For example, the plans do not identify serious issues relating to health and sexualised behaviour towards staff and peers, nor do they outline strategies to address these issues. Staff do not follow the organisation‟s procedures for the safe storage, handling and administration of medication. Old medication has not been disposed of. Some medication is not dated or labelled. The key to the internal controlled medication cabinet could not be found. These weaknesses leave children at risk.

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Overall experiences and progress of children and young people: inadequate

Children attend school and are making some academic progress. There are systems in place to ensure that staff liaise with education colleagues on a daily basis. This helps to maintain clear lines of communication. However, records of meetings with education professionals are not recorded. Personal education plans and education, health and care plans are not on file and therefore not available to children or staff. Staff are, therefore, not informed of further actions that need to take place to improve children‟s educational outcomes further. Children are supported to maintain relationships with their families. Staff recognise the importance of this contact and support these sessions. Children benefit from support from the company‟s clinical team. One child is participating in regular therapy sessions. Inspection report children‟s home: SC449245 7

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

There has been a lack of effective management oversight. Safeguarding practices have not be monitored or reviewed. Consequently, staff have failed to keep children and themselves safe. Children use highly sexualised language, gestures and inappropriate touching towards each other and staff. A lack of guidance for staff means that their interventions are unsuccessful. Staff are managing the environment by separating the children. This strategy has not been successful and the police have been called to resolve issues that staff cannot manage. These behaviours are not identified in children‟s risk assessments, placement plans or behaviour management plans. Staff have been raising concerns about the children living together, and about the lack of training and guidance for staff, in staff meetings with the previous registered manager since September 2017. Staff have still not been provided with training and they do not have the skills to manage relationships between the

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

children to prevent them from harming each other. Staff do not ensure that children use the internet safely or only access age-appropriate computer games. Children have had unsupervised access to the internet using the staff password. This is not in line with the children‟s risk assessments or the organisation‟s policy. The new manager has removed a mobile phone and iPad. She is also reviewing children‟s internet history to ensure that there are no safeguarding concerns that need to be referred to partner agencies. Out of the 13 members of staff, 12 have not received training in e-safety and do not have the skills to ensure that children are kept safe online. Poor management oversight of physical restraint fails to safeguard children or staff. Staff do not talk to children in a timely manner following a physical restraint. There are no records of conversations between the registered manager and staff about their restraint

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

practice. Staff are not encouraged to reflect on their practice or improve their behaviour management strategies. Consequently, poor, ineffective practice has been allowed to continue. Children and staff do not live and work in a safe environment. Six out of the 13 staff have not attended fire training. Children have had access to dangerous areas in the home. Broken locks to the boiler room and oil tank were only fixed on the second day of this inspection. Staff are currently sleeping in a room that smells of damp. A (currently unoccupied) child‟s bedroom smells strongly of urine. These shortfalls are unacceptable and place both children and staff at risk. A new manager started on 1 January 2018. She has taken some initial action in relation to some concerns. However, these changes have had little time to embed or their effectiveness to be assessed. She has identified the concerning sexualised behaviours

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

exhibited by the children. The new manager has discussed the current concerns with the local authority safeguarding lead and has called emergency planning meetings with the placing authorities. Inspection report children‟s home: SC449245 8 The house is not homely or welcoming. Furniture is broken in every room. There are very few pictures on the walls. As a result, children do not live in a comfortable, nurturing environment. This impacts on the children‟s emotional well-being. The new manager has contacted the organisation‟s maintenance team and damage to the property was being repaired and broken furniture removed during this inspection.

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The effectiveness of leaders and managers: inadequate

A shortfall in leadership and management has resulted in:  poor safeguarding and behaviour management practice  a lack of effective leadership and management oversight  poor-quality, unreliable or missing records  poor medication arrangements  poor staff supervision, appraisal and training  ineffective internal and external quality assurance. The practice of the previous registered manager has resulted in significant leadership and management shortfalls. Internal and external monitoring and review systems did not identify these issues. The responsible individual was not aware of the extent of the management failings. Poor, unsafe practice has not been addressed. Children have not been protected. Concerns about the registered manager were raised by a local authority. Subsequently, the responsible individual undertook a thorough investigation. The internal investigation has now been concluded and shared with Ofsted and other agencies.

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The effectiveness of leaders and managers: inadequate

The new manager is suitably experienced. She is in the process of consulting with staff and partner agencies. She is working with the responsible individual to develop an action plan to address the considerable shortfalls. The previous registered manager did not share key information about children‟s behaviour and progress with their placing authorities. This left children unprotected and placing authorities unaware of serious issues. Staff do not complete effective inductions. They do not receive regular supervision or annual appraisals to ensure that their practice is reviewed against the needs of the children. Staff do not have any debriefing after significant behavioural incidents such as restraint. These ongoing shortfalls mean that staff do not have adequate support. They do not reflect on their practice and are unable to achieve high standards of care for children. Staff do not have the skills that they require to meet the needs of children because they

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The effectiveness of leaders and managers: inadequate

have not received training. Although the organisation has a programme of mandatory and refresher training, staff from this home have not been supported to attend. As a result, not enough staff have training in the ethos of the organisation or the key issues faced by children. Inspection report children‟s home: SC449245 9 For example, 11 out of the 13 staff have not completed training in reflective practice and 11 out of 13 staff have not completed training in attachment theory. The home‟s statement of purpose does not contain up-to-date information on the new staff team. Parents and carers, placing authorities and advocates do not have the information that they need to make sure that children are receiving the service intended.

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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: SC449245 10

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Children’s home details

Registered provider address: Edward James House, Hadley, Telford TF1 6QJ

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Inspector

Dawn Bennett, social care inspector Inspection report children‟s home: SC449245 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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