Children's Home run by Pathway Care Solutions Ltd in Nottinghamshire

SC390190 Unique reference number 17 June 2010 Inspection date Mark Ryder Inspector Key Type of Inspection

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This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

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You can obtain copies of The Children Act 2004, Every Child Matters and The National Minimum Standards for Children's Services from: The Stationery Office (TSO) PO Box 29, St Cripins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop

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About this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000. This report details the main strengths and any areas for improvement identified during the inspection. The judgements included in the report are made in relation to the outcome for children set out in the Children Act 2004 and relevant National Minimum Standards for the establishment.

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The inspection judgements and what they mean

this aspect of the provision is of exceptionally high quality Outstanding: this aspect of the provision is strong Good: this aspect of the provision is sound Satisfactory: this aspect of the provision is not good enough Inadequate: 3 of 9 Inspection Report: SC390190

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Brief description of the service

This children's home operates out of a newly-built home on the outskirts of a city centre. It offers care and accommodation for three young people with emotional or behavioural problems between the ages of eight and 17 years. Three young people currently reside at the home. All participated in the inspection process.

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Brief description of the service

The home is a detached house with a lounge, dining room, activity room and kitchen on the ground floor. On the first and second floors there are three bedrooms, a bathroom and office. Two bedrooms have en suite facilities. The office is also a staff sleeping-in room. There is a small enclosed garden and patio area at the rear of the property. The home is within walking distance of shops and there are regular bus services into the city centre.

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Summary

This is an unannounced full inspection in which all the key national minimum standards were assessed. The home has mainly good outcomes with one outstanding aspect. Previous recommendations have been met. The home continues to promote the welfare and interests of the young people they care for. Consultation with young people is particularly good. Contact with family and friends is very well managed, which young people find supportive. Education and activities are promoted with outstanding outcomes. The home has five good practice recommendations and one action to further improve the service. However, the impact on these shortfalls on young people has been assessed as being minimal in relation to the very positive practice within this home. The overall quality rating is good. This is an overview of what the inspector found during the inspection.

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Improvements since the last inspection

The home received two recommendations for good practice at the last inspection. Both have been addressed. The policy on anti-bullying now refers to all known strategies for countering cyber bullying. Activities and planned trips out are now fully risk assessed.

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Helping children to be healthy

The provision is good. The health and well-being of young people is promoted at this home. Staff support young people to attend health appointments, such as visits to the dentist, general practitioners (GP) and opticians. Recording of when young people attend such appointments ensures that young people's health needs are regularly monitored. Health care plans provide details of a young person's medical background including immunisations, vaccinations and any allergies. This ensures staff are aware of a young person's medical conditions and what they need to be aware of when caring for them. Young people are able to choose if they wish to see a male or female doctor.

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Helping children to be healthy

Menus of planned meals and what was actually served are considered by both young people and the staff. In most cases the diets of young people are nutritionally balanced including fresh vegetables and fruit as well as more commonly enjoyed food, such as takeaways. However, this is not consistent practice for all young people. Culturally diverse meals are available and reflected 4 of 9 Inspection Report: SC390190 within the menu planner. Young people express positive comments regarding the food provided within this home. A young person wrote that 'we cook healthy meals'.

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Helping children to be healthy

Administration of medication is managed well within this home. There is a robust monitoring process ensuring that an audit of all prescribed and non-prescribed medication is accounted for. Staff receive regular training on the safe administration of medication. All medication is appropriately stored.

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Protecting children from harm or neglect and helping them stay safe

The provision is good. Safety measures within this home ensure young people, staff and visitors are suitably protected. There are regular checks on fire safety, electrical and gas installations. Portable appliance tests are annually checked and potential hazardous substances are risk assessed and kept safe. Risk assessments, including assessments for activities and trips, are undertaken to ensure all foreseeable circumstances are considered. This is an improvement since the last inspection.

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Protecting children from harm or neglect and helping them stay safe

Checks and vetting procedures on staff are carried out before they work with children and young people. There is robust monitoring of recruitment practice. Criminal Records Bureau (CRB) checks, references from previous employers and explanations in any gaps in employment histories are recorded within staff files. There are identification checks on visitors and a signing in and out procedure. Visitors who do not have the necessary identification are supervised during their visit. This means that young people are further protected.

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Protecting children from harm or neglect and helping them stay safe

Complaints about the service are recorded, actioned and responded to in a timely manner. Young people are aware of the complaints process. The organisation's policy on complaints includes both the present and previous regulatory body's contact details. This could be confusing to staff or other persons wishing to make a complaint about the home.

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Protecting children from harm or neglect and helping them stay safe

Privacy of young people is central to this home. Staff are aware of respecting a young person's personal space, although on one occasion a young person felt this was not the case. However, staff are aware of the policy on privacy and are clear that they would, for example, knock on bedroom doors before entering. Confidentiality of personal and sensitive information is appropriately managed within this home.

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Protecting children from harm or neglect and helping them stay safe

Young people report that bullying is not a concern at this home. However, when it does occur, young people say that staff act quickly and sanction the person who is bullying. The organisation's policy on recognising and responding to bullying behaviour now includes all possible forms of bullying including the use of cyber bullying. This is an improvement since the last inspection.

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Protecting children from harm or neglect and helping them stay safe

Incidents of young people who are absent without authority are responded to in accordance with the organisation's policy and procedures. Risk assessments on a young person's level of vulnerability are updated and passed to the police and social workers promptly. Staff welcome young people back to the home when they return and seek to reassure and address the reasons for running away. There is clear and well documented keyworking records which demonstrate this. Young people said they felt listened to when they returned to the home.

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Protecting children from harm or neglect and helping them stay safe

Staff receive regular training in safeguarding practice and are aware of the indicators of abuse and what actions to take if a young person makes a disclosure. Staff have access to the Local 5 of 9 Inspection Report: SC390190 Safeguarding Children Board (LSCB) procedures as well as the organisation's own procedures to refer to in such an event. Social workers are pleased with the level of communication received from the home about young people.

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Protecting children from harm or neglect and helping them stay safe

Behaviour management of young people is managed by competent and well-trained staff. All staff receive suitable and specific training on de-escalating potential volatile situations and using safe and accredited physical intervention techniques. Incidents that involve the use of restraint are recorded and checked by the manager. Whilst records accurately reflect the actions taken to address a young person's behaviour it is unclear if young people are routinely asked if they wish to see a nurse or GP after they are held.

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Helping children achieve well and enjoy what they do

The provision is outstanding. Young people receive individual support to meet their needs. Staff consult with a psychotherapist to help them support and assist young people. Direct therapeutic support is also provided for young people on a regular basis. This is a particular strength of the service. Keyworking sessions and house meetings encourage young people to discuss any concerns or views about their care. A young person said 'we can always talk to staff about how we are feeling'.

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Helping children achieve well and enjoy what they do

Staff are aware of the potential for discrimination against the young people who live in residential child care. The staff encourage young people to be fully engaged with in the local community through sport and recreational pursuits. The home's ethos is to respect each young person's individuality and to help them live as normal a life as possible.

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Helping children achieve well and enjoy what they do

Education is promoted at this home. All young people engage in some level of education and are provided with incentives to further support their attendance at school or other educational provisions. A timetable of activities, that includes educational time, is recorded and kept up-to-date so that young people and staff are aware of the plan for the week. Personal educational plans (PEPs) provide details of each young person's educational targets. These are regularly reviewed. Young people have been recently assessed as having the potential to achieve to a high educational attainment. This is a particularly strong aspect of this service.

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Helping children achieve well and enjoy what they do

Activities for the young people to pursue and enjoy are a regular part of placement. Weekly activity planners reflect the diverse range of recreational interests of the young people. The home provides financial support to each young person so that they can engage in any sport or hobbies of their choosing. For example, young people are able to play football and snooker on a regular basis as well as golf, bike riding, rock climbing and day trips out. A young person said that the activities they are able to do is the best part of living at this home.

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Helping children make a positive contribution

The provision is good. Care planning and practice within this home contribute to young people being provided with a good level of care. Placement plans include all essential information about a young person to help staff manage and care for them in a safe way. Risk assessments are updated on a regular basis and provide detailed information. Placement plans are discussed with young people, although the plans themselves are not written in a style that young people would find easy to understand. Culture, race and religion are very well reflected within the placement plans. 6 of 9 Inspection Report: SC390190 Review of the arrangements for the placement are held within timescales. Young people are consulted about their care and are invited to all such meetings. A young person said that they were able to talk about what they wanted to happen in their life at such a meeting. The home provides a detailed report to the review meeting about the young person's development. The

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Helping children make a positive contribution

minutes of these meetings refer to actions required to meet the objectives of the placement.

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Helping children make a positive contribution

Young people are able to maintain contact with their families and close friends. Staff encourage, such contact and help with both transport and, if required, space within the home to meet. The staff also supervise contact when needed and provide reports on such contacts to the social worker. A social worker wrote that there was 'very good communication between the staff and the department regarding contact arrangements'.

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Helping children make a positive contribution

Young people felt that staff listen to them and that they are able to discuss any concerns within the team. There are regular key working meetings between young people and staff which are recorded and kept on file. Keyworking meetings discuss a range of relevant topics such as reasons for running away, helping a young person get used to living at the home and advise on stopping smoking. Young people's meetings are held monthly and are recorded. Discussions refer to planned holidays, behaviour and the complaints. All young people are included in these meetings and are helped to express their own personal opinions and views.

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Achieving economic wellbeing

The provision is good. The home provides support and encouragement for young people to develop their independent skills. Review meetings monitor whether pathway plans are required and what other resources are needed to help young people develop the skills needed for adulthood. A young person wrote when asked what the home does to prepare them for independent living that staff 'teach me to cook, clean and be more hygienic'. A social worker explained that the staff 'constantly prepare the children for the future'.

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Achieving economic wellbeing

The accommodation is suitably furnished and well maintained for the young people to live comfortably. Young people can personalise their rooms and are consulted about the colour scheme for the house which is presently being redecorated. Young people's bedrooms do not all have, however, a lockable facility or bedside lamps for reading. This is an area for improvement.

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Achieving economic wellbeing

The home's garden is well maintained and provides young people an opportunity to grow their own fruit and vegetables. A young person expressed positive comments about being able to garden and the support they received from the staff.

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Organisation

The organisation is good. The Statement of Purpose accurately reflects the practice and functions within this home. This document is regularly reviewed in light of progress and development of the service. The young person's guide is available and is written in a child-friendly style.

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Organisation

Staff expressed positive comments regarding the support and training received whilst working at this home. Informal discussions and team meetings between the Registered Manager and staff ensure that there is a good level of communication within this home. However, formal 7 of 9 Inspection Report: SC390190 supervisions are not held regularly. Appraisals are also three months out-of-date. The manager is aware of the present difficulties and has highlighted this situation through their own supervision and monitoring records. This is an area for improvement.

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Organisation

The team includes experienced and skilled staff in working with young people with emotional and behavioural difficulties. Staffing levels are appropriate for the needs of the young people. The team meets the minimum standards in completing the National Vocational Qualification (NVQ) at level 3 in caring for children and young people.

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Organisation

The promotion of equality and diversity is good. Young people are provided with a positive experience within their placement that meets their individual needs. Cultural, racial and religious needs are met and fully recorded within placement plans. Staff are mindful of the impact on young people living in children home and the stigma and discrimination that can arise from this. The staff team composition reflects the diversity of the young people in placement.

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Organisation

Monitoring of the home's practice and records are completed on a regular basis. The Registered Manager signs the home's records at least once a month. Monthly visits from a senior member of the organisation identifies areas for improvement as well as positive aspects of this home. The home's records reflect the needs and progress of each young people in placement. Young people are able to access their records, although this is not common practice within this home.

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Organisation

Social workers were particularly impressed with the quality of the care provided by this team. A social worker commented on a pre-inspection survey that staff and management at this home are excellent. They work together as one for the good of the children. I wish all residential homes were as good.'

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Statutory requirements

This section sets out the actions, which must be taken so that the registered person meets the Care Standards Act 2000, The Childrens Homes Regulations 2001 and the National Minimum Standards. The Registered Provider must comply with the given timescales.

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Due date Action Standard

9 July 2010 update the complaints procedure to include the name, address and telephone number of the present regulatory body. (Regulation 24.4)

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Recommendations

To improve the quality and standards of care further the registered person should take account of the following recommendation(s): • ensure that the record of menus (as served) demonstrates provision of a suitable and varied diet (NMS 10.4) • ensure that the home and staff respect a child's wish for privacy as is consistent with good parenting and the need to protect a child (NMS 9.1) • ensure that where there has been physical intervention, the child will have the right to be examined by a registered nurse or medical practitioner within 24 hours (NMS 22.13) 8 of 9 Inspection Report: SC390190 • ensure that each child has a lockable or otherwise safe storage for personal possessions and lighting sufficient to read by (NMS 24.5) • ensure that all staff receive at least one and a half hours of one to one supervisions from a senior member of staff each month (NMS 28.2) 9 of 9 Inspection Report: SC390190

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