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

Unique reference number SC051739 Inspection date 11/03/2011 Inspector Mark Ryder Type of inspection Key

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Date of last inspection 25/05/2010 Website: www.ofsted.gov.uk

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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 Crispins, 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.

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About this inspection

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 outcomes for children set out in the Children Act 2004 and the relevant National Minimum Standards for the service.

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The inspection judgements and what they mean

Outstanding: this aspect of the provision is of exceptionally high quality Good: this aspect of the provision is strong Satisfactory: this aspect of the provision is sound Inadequate: this aspect of the provision is not good enough

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Brief description of the service

This children’s home is a large detached house situated in a residential area on the outskirts of a city. It is within easy access of local community resources. Although registered for three young people with learning disabilities, the home currently only has two young people who are not assessed as having learning disabilities. There is a sensory room/sleeping in room. The home also has a bathroom, two toilets, a lounge, a resource room, a kitchen, a staff office and a garden. The home is part of an organisation which has several homes within the area. At the time of this inspection two young people were in placement and contributed to this inspection.

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Summary

The overall quality rating is satisfactory.

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Summary

This is an overview of what the inspector found during the inspection.

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Summary

This was an unannounced full inspection in which all key standards were assessed. This is a satisfactory service with some good aspects. Health and educational needs are well met by a staff team that works effectively with the care of young people. Young people felt listened too and respected. There is a positive approach to the care of young people with complex needs.

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Summary

There were, however, areas for development. The home is presently not working within their category of registration. This means the service does not accurately reflect the type of young person who should be cared for. Significant events affecting the welfare of young people are not routinely notified to Ofsted and the home does not have a Registered Manager in place. Not all staff have current training in the safe use of physical intervention and supervisions are not held regularly. Medication stored in a fridge does not have a lock to ensure security of such medications.

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Improvements since the last inspection

There was one action from the last inspection which remains unmet. The provider was asked to put forward a suitable manager to be registered with Ofsted. While it is recognised that there are difficulties in recruiting, the present situation is not sustainable for the long term. The lack of consistent management oversight impacts on the overall effectiveness of this provision.

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Helping children to be healthy

Young people's health needs are met by a competent staff team. Meals are varied, nutritious and include personal choice by the young people. Staff consult with young people and prepare menus on a weekly basis. Young people were positive about the food served. A young person said 'the staff really help me eat healthily'. Individual dietary needs that reflect cultural or medical backgrounds are met. For example, staff prepare meals for young people who require specialist diets. Meal times are social events with staff and young people sitting and eating together. Staff feel this is an important part of the day and helps to establish relationships with the young people.

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Helping children to be healthy

Staff support young people to attend medical appointments when required. All young people are registered with a local doctor, dentist and optician. Health care plans include young people's medical history and present health needs. Staff update plans on a regular basis to reflect any changes. This ensures that the staff team are fully aware of each young person's medical situation. There are sufficient number of staff on duty at all times who are trained in first aid.

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Helping children to be healthy

Staff administer medication following the organisation's policy and guidance. This is clearly presented and all staff who give out medication are aware of it. Staff receive regular training and medical guidance on a number of aspects of administering medication safely such as subcutaneous injections. Prescribed medication is kept in blister packs which reduces the possibility of medication errors. There is a lockable medication cabinet which is only accessed by staff. However, a fridge designated for the purpose of keeping liquid medicine at the correct temperature is not lockable. This could compromise the security of medications.

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Protecting children from harm or neglect and helping them stay safe

Staff provide an atmosphere where privacy and dignity is valued. For example, young people can speak to family members privately. Young people's personal space is respected and confidential information is sensitively handled. Young people are aware of their right to make a complaint if they are not happy with any aspect of their placements. Staff ensure all young people are aware of the complaints procedures regardless of disability. Complaints are dealt with without delay.

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Protecting children from harm or neglect and helping them stay safe

Staff are aware of keeping young people safe through awareness of potential risks with regards to behaviour and vulnerability. Staff receive safeguarding training during their induction and refresher courses at regular intervals. There are safeguarding procedures available which are followed. Referrals to the local authority are made within timescales although notification to Ofsted is inconsistent. This means the regulator is not always fully aware of the actions taken to keep young people safe prior to inspection. Bullying incidents are low at this home. Staff supervise the young people throughout the day due to their differing needs. However, relationships between residents are generally positive. A young person said 'we get on ok here, there is no bullying'.

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Protecting children from harm or neglect and helping them stay safe

Staff support young people in crisis through consistent and clear boundaries. Staff understand the role they have at this home and how to communicate with young people who can be both physically and verbally challenging. Most staff are trained in effective and safe use of restraint. However, a number of new staff have not had this training to date. This could potentially put young people and themselves at risk of injury.

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Protecting children from harm or neglect and helping them stay safe

Staff are fully aware of the reporting procedures for when young people are missing or are absent. The level of risk to a young person is regularly assessed. However, such incidents are presently infrequent. Staffing levels provide consistent supervision to young people due to their specific needs.

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Protecting children from harm or neglect and helping them stay safe

Physical safety of the home is robust. Both portable and hard wired electrical appliances are tested within suitable timescales. Similarly gas appliances are maintained every 12 months. Staff and young people are aware of fire evacuation procedures through regular drills. Checks on fire alarms and other fire prevention measures are regularly adhered to. This means that young people, staff and visitors are safe when living or working in the building.

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Protecting children from harm or neglect and helping them stay safe

All staff have checks from the Criminal Records Bureau and supportive references from their last employer. Gaps in employment histories are accounted for. Careful selection and vetting of staff prevents young people being exposed to unsuitable individuals.

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Helping children achieve well and enjoy what they do

Education, individual support and recreational activities are provided for young people to help them develop into adulthood. Education is actively promoted to help young people gain the most from their time in placement. A range of educational packages are available to meet the individual needs of young people. Education plans identify achievable targets. Young people who require additional support at school receive support from staff. Young people benefit from this as well as the resources within the home that provide learning and creative opportunities. For example, young people are encouraged to cook and bake to develop such skills.

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Helping children achieve well and enjoy what they do

Young people say that they are able to talk about any concerns with members of staff not just with their key workers. Staff ensure that the dynamics remain positive and that no one is excluded due to disability or behaviour.

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Helping children make a positive contribution

Placement plans reflect individuality and the assessed needs of young people. Education plans, contact arrangements and medical information are available. Plans refer to young people's culture, religion and disability. Young people are able to access their plans and fully contribute to the content. A review of the arrangements for placements are held within timescales and involve young people and parents. Young people play an active and positive role within these meetings, contributing to their own future plans and decisions. A young person said that they attended part of their review meeting and was helped to say how they felt about the placement.

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Helping children make a positive contribution

Parents are welcome at this home. There is a current record of all contact arrangements which is regularly reviewed. Young people are able to express their views and opinions about their care. Staff respond positively to this, encouraging young people to contribute to their placements.

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Achieving economic wellbeing

The accommodation is structurally sound and provides a pleasant domestic environment to live. Young people are encouraged to personalise their rooms to their own tastes. Any damages are promptly repaired. Young people say they enjoy living at this home. Staff encourage young people to develop independent skills, taking into consideration their situation, attitude and understanding. For example, for some young people they are able to cook, shop for their own clothes and manage a budget. For others a more supportive approach is required. A young person said 'I try and do a lot for myself. I need to be able to do this when I'm older'.

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Organisation

The home is presently caring for young people with emotional and behavioural difficulties. Therefore, the condition of registration for the care of young people with learning disabilities has not been met. This means that the service is working outside of its criteria and is breeching its initial registration approval. However, in spite of this situation staff do present as having the skills and understanding of caring for young people with complex behavioural and emotional needs. An action has therefore been made for the service to apply for the correct categorisation.

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Organisation

The home continues not to have a permanent Registered Manager in place. This has the potential to compromise the development of the service. Present management oversight is, however, satisfactory for the short term. Monitoring of the home is consistent and identifies areas to improve. There is a comprehensive training and induction package for staff to professionally develop. Staff say they have the full support of the management team although formal supervisions are not held regularly. This may impact in being able to identify and support staff within a supervision structure.

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Organisation

The promotion of equality and diversity is good. The composition of the staff team reflects the gender balance of the group of residents. Staff are aware of issues that may discriminate against young people who live in residential care and support and advise young people to live as full lives as possible.

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Organisation

There are sufficient numbers of staff on duty at any one time to care for and support the young people. Young people's needs, development and progress are accurately recorded to reflect their individuality.

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Statutory Requirements

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

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Std. Action Due date

1 ensure the requirement to comply with a condition of registration is met with reference to caring for children with emotional or behavioural difficulties (Care Standards Act 2000 section 24) 18/04/2011

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Std. Action Due date

20 notify without delay the relevant persons or agencies of the matters set out in Schedule 5 in particular the instigation and outcome of any child protection enquiry involving a child accommodated at the home (Regulation 30.1) 11/04/2011

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Std. Action Due date

34 submit an application to Ofsted for the registration of a manager for the children's home. (Regulation 7) 06/05/2011

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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):

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Recommendations

 ensure medication is stored securely with regards to the unlocked fridge (NMS 13.10)  ensure all staff have suitable training in the safe use of physical intervention (NMS 22.8)  ensure all staff receive at least one and a half hours of one-to-one supervision from a senior member of staff each month. (NMS 28.2)

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