Children's home run by Pathway Care Solutions Ltd in Sheffield

Unique reference number SC391594 Inspection date 10/07/2012 Inspector Debbie Foster Type of inspection Full Provision subtype Children's home

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Date of last inspection 02/02/2012 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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Brief description of the service

This children's home is privately owned and provides care and accommodation for up to three children of either gender, between the ages of eight and 17 who have a learning disability.

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Brief description of the service

The home is fitted with minor aids and adaptations to help support children who may also have a physical disability.

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The inspection judgements and what they mean

Outstanding : a service of exceptional quality that significantly exceeds minimum requirements Good : a service of high quality that exceeds minimum requirements Adequate : a service that only meets minimum requirements Inadequate : a service that does not meet minimum requirements

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Overall effectiveness

The overall effectiveness is judged to be good .

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Overall effectiveness

Young people live in a calm and supportive home environment that enables them to make good progress. They are protected from harm and are looked after by caring staff that are committed to helping young people to gain positive social and independence skills which will support them into adulthood. Young people enjoy strong and trusting relationships with staff, which gives them confidence and assists them in keeping safe and making progress educationally.

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Overall effectiveness

Young people are listened to and respected by staff. Young people like their home. Care planning is individualised. Staff work in a coordinated way with young people, their families and relevant professionals to ensure young people get the right support they need.

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Overall effectiveness

The home is effectively managed. The manager is committed to ensuring young people are provided with a good standard of care, ensuring continuous improvement. Some areas for attention are identified. Some aspects of the care plan are not specific and the progress made by young people is not always clearly documented. Essential training relating to physical intervention is not always provided at the point of the staff induction to working in the home, before commencing their work with young people. Training relating to caring for young people with severe learning disabilities is not extensive. Employment gaps are not always explained and recorded as part of the staff recruitment documentation. Prompt action is not always taken to replace furniture and fittings in the home.

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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 person(s) must comply with the given timescales.

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Reg. Requirement Due date

(2001) ensure that for all persons employed in the home satisfactory information is available in respect of each of the matters specified in Schedule 2. In particular that a full employment history is kept, together with a satisfactory written explanation of any gaps in employment (Regulation 26 (b) (d) schedule 2 (6)) 28/08/2012

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Recommendations

To improve the quality and standards of care further the service should take account of the following recommendation(s):

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Recommendations

 ensure that each child’s placement plan is monitored by a key worker within the home who ensures that the requirements of the plan are implemented. In particular ensuring all areas of the plan are specific and clearly evidence the progress each young person is making (NMS 25.2)  ensure the home provides a comfortable environment that is well maintained and decorated; in particular that damaged furnishings are repaired or replaced at the earliest opportunity and the window replacement and refurbishment is completed (NMS 10.3)  ensure all staff are trained in the use of physical restraint techniques and only use the home's agreed techniques. In particular, providing this training to new staff before commencement of working with young people (NMS 3.15)  build further on ensuring all staff are equipped with the skills required to meet the needs of the children and professional, legal and practice developments and

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Recommendations

reflects the policies, legal obligations and business needs of the home. In particular, extending the training in caring, supporting and meeting the needs of young people with severe learning disabilities. (NMS 18.1)

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Outcomes for children and young people

Outcomes for children and young people are good . Young people have positive relationships with staff members who are supporting them to develop routines, adapt to their surroundings and change, which at times can cause anxiety in their everyday lives. Young people are at varying stages in expressing their wishes and feelings to staff and this continues to improve. A parent said that their child's communication skills have improved since living at the home. This is achieved through staff clear verbal communication, supported by the use of sign language, pictures, and symbols and pointing.

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Outcomes for children and young people

Young people are supported to develop healthy lifestyles and this includes young people attending health appointments and assessments. This has brought about some improved health outcomes for young people. Staff are working with other professionals to address issues where young people's anxiety levels prevent them attending some health appointments. Young people are supported to eat balanced diets to maintain healthy outcomes. Staff demonstrate a good awareness and provide for special and cultural diets.

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Outcomes for children and young people

Young people are attending full-time education. Some young people have started a new school since their admission and a carefully planned transition for this has brought success, in them settling in well. Staff are supportive and committed to ensure regular attendance for each young person in their educational placements. Well-maintained daily routines are in place, which supports young people's education. Young people are making educational progress through achieving their personal educational goals and targets.

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Outcomes for children and young people

Young people have regular positive contact with family, friends and significant others. This promotes their identity needs and sense of belonging. Where difficulties arise with contact, staff work to address this issue. A parent said 'The staff are excellent, I see my son twice a week, staff are in constant contact by phone and I'm kept well informed. I can phone them, they are really approachable, this is so important to me and my family.' This ensures improved communication and understanding between all parties, which is in young people’s best interests.

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Outcomes for children and young people

Young people are well supported by staff to practise and gain life and independence skills. Young people have made good progress in this area. This includes: setting the table and helping to clear away; making cold drinks and preparing snacks with staff support, and assisting more with their own personal care. These are appropriate to their age and understanding and have been identified in their care plan for promoting their independence further. A young person proudly said 'I set and clear the table now.'

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Outcomes for children and young people

Young people's experience of accessing their local community and activities is varied. Some are routinely getting out and about and have made good progress from the starting point of their placements. For example they have been involved in going to local shops, attending home visits, accessing community hairdressers, visits to parks and eating out. Other young people have a more sporadic experience accessing outside activities, which is affected by their anxiety levels. Staff are working with other professionals to support young people with these barriers to assist in moving this forward. There was good interaction between everyone with chatter, laughter, communication through signing and lots of smiling faces. A parent said 'I am pleased my son is about to join a youth group where he will be meeting more young people his own age.' This is broadening young people's life experiences, social skills and is

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Outcomes for children and young people

assisting in developing their self-confidence.

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Quality of care

In the main young people's individual needs are identified in care plans and other supporting documents. Care plans are regularly reviewed and updated. All aspects of care planning and care practice recognise young people as individuals and place their well-being at the centre of staff practice. Staff have a good awareness about young people's needs. They work in a committed manner to put plans into practice to ensure young people's needs are met on a day-to-day basis. However, some elements of the care plan guidance are not specific and it is not always clear how work with young people is progressing. Therefore, this is not on all occasions evidencing clearly or identifying continued areas of support that young people require or where progress is being made in their lives.

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Quality of care

Staff say young people clearly let them know when they are not happy about something. Any change in a young person would be investigated to establish what has caused this. The service has devised a complaints format which young people with learning disabilities can more easily understand and use to explain any concerns or complaints. This has been shown to young people and explained. Staff are clear on what to do in the event of receiving a complaint. Any complaint received is clearly recorded to reflect the action taken by the staff and the outcome.

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Quality of care

Effective policies and practice around the storage, handling, administration and disposal of medication safeguard young people's welfare.

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Quality of care

Young people’s views are genuinely sought and acted upon. These involve making choices about the meals they eat, how they spend their time in their own home, the activities they undertake and contact with their families. Staff can verbalise how each young person communicates their choices and recognise when young people are not happy and make choices not to participate. Young people have been involved with parents in personalising their own bedrooms, which reflects their personality and interests. This gives young people some autonomy over their own lives.

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Quality of care

The staff appreciate that individual young people have needs arising from diversity. The young people receive individualised care and support. Where necessary, staff ensure support services are involved in the health, care, safety and education of the young people. The home has links with other helping agencies, and this has helped to provide services to suit each individual young person.

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Quality of care

Young people live in a residential location that affords them good access to a range of local community facilities. Externally, the home is well maintained and blends in well with other houses on the street. Overall the house is decorated and furnished to a good standard. However, there has not been a quick response to the replacement of a broken settee. There has been a refurbishment programme for the windows in the house, this is only partially completed, and no planned dates to complete the rest have been set. This is not proving to be effective and affects the overall quality and daily experience for the young people living at the home.

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Safeguarding children and young people

The service is good at keeping children and young people safe and feeling safe.

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Safeguarding children and young people

Staff and two parents said that young people are safe living at the home. Where particular risks are identified, consistently well-written risk assessments are recorded to help the staff understand what action to take to minimise the identified risks. Applying these consistently to young people assists in developing young people’s understanding. As a result, young people's risk-taking behaviours reduce and they feel cared, secure for and protected.

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Safeguarding children and young people

The provider has very good safeguarding systems and procedures for staff to follow in the event of any allegation or suspicion of abuse. These have been implemented. The manager and staff have received child protection training. Staff demonstrate a good knowledge and understanding of the safeguarding procedures to promote and protect young people’s safety. There is good written guidance for staff to follow in the event of unauthorised absence. This is supported by individualised risk assessment records. There have been no incidents of bullying or young people going missing.

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Safeguarding children and young people

Staff explain that physical restraint is undertaken as a last resort. Seven interventions have occurred since the last inspection and incidents have started to reduce in number. The child and adolescent mental health services are supporting and working with staff to assist in supporting young people more effectively to improve their daily lives and management of anxieties. Physical intervention has been used to protect young people from self-harm and hurting others. The majority of staff are trained in the provider’s de-escalation policy and authorised intervention techniques. Events are recorded and there is evidence that it is monitored well to identify patterns or trends that can be used to support young people further. Further professional guidance has also been sought to support young people with behaviour difficulties.

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Safeguarding children and young people

Regular fire safety checks, general checks and maintenance arrangements ensure the home is physically safe place for young people to live. All staff have received fire instruction and safety training to enable them to minimise the risks to young people in the event of a fire at the home.

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Safeguarding children and young people

All staff recruited, undergo suitable Criminal Records Bureau checks and references are taken up to check out their suitability to work with young people. However, shortfalls have been found in some of the staff files sampled. There is not a full employment history recorded for all staff and gaps where not explained in the records. This does not ensure that all relevant and required avenues have been thoroughly checked out to check full suitability of all individuals to work with young people. This may impact on young people's safety.

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Leadership and management

The leadership and management of the children's home are good .

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Leadership and management

The home is effectively run by an experienced manager who is registered with Ofsted. In the absence of the manager the assistant manager deputises. They complement each other, working well as a team and are focussed on the needs of young people in their care. Managers have established positive links with other agencies and work in partnership with social workers, some health and education professionals to promote improved outcomes for young people.

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Leadership and management

The Statement of Purpose clearly outlines the aims and objectives of the home and young people, staff and social workers are clear about the services and support the home provides. The manager has a good understanding of the home’s strengths and areas of weakness. Monitoring of the service has shown shortfalls and prompt action is taken to address these.

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Leadership and management

The manager has positively addressed the recommendations from the previous inspection. A clear system has been established to send a summary of the managers monitoring of the service to Ofsted at regular intervals. New staff completing their probationary period are registered and undertaking the Children and young people's workforce diploma qualification. A complaints format has been devised in an appropriate format which young people with learning disabilities will be able to more readily understand and use.

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Leadership and management

The manager has an effective system to monitor and evaluate the home’s records, quality of care and outcomes for young people. In addition the home is visited monthly by external visitors who undertake regulation 33 monitoring visits. A report is published following each visit and the manager and staff take the necessary action to address any areas needing review.

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Leadership and management

Young people are looked after by a core number of experienced staff who have worked with them since the start of their placements. The home has recently recruited new staff, who have completed their induction and currently are settling into their new roles and getting to know young people. New staff work alongside experienced staff members to ensure a good standard of care is maintained.

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Leadership and management

Staff show high levels of commitment and dedication to young people. All staff receive regular supervision and attend staff meetings. Staff say ' I can approach the manager any time to discuss any matter.' There are structured daily handovers which include good shift planning to ensure staff are clear on the care and support young people require to meet their needs.

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Leadership and management

Staff undertake mandatory training, including; safeguarding, first aid, food hygiene behaviour management and the safe management of medication. In addition staff receive training in autism, learning disability, child development and attachment. This provides staff with good opportunities to develop their skills, knowledge and practice to enable them to safely meet the needs of young people. Shortfalls in the training provided to some staff have been found. The training in the conditions and needs of young people with severe learning disability is not extensive. Not all new staff have received physical intervention training prior to starting working with the young people. As a result, this could impact negatively on the standard of care delivered to young people. Therefore, new staff may lack understanding, knowledge and skills to enable them respond appropriately to all the care needs of the young people.

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Leadership and management

Staff are aware of the need for confidentiality and always ensure young people's written records are stored securely. As a result, records provide essential information and insight that contributes to an understanding of young people's lives.

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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 to assess the effectiveness of the service and to consider how well it complies with the relevant regulations and meets the national minimum standards.

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About this inspection

The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made against the Inspections of children’s homes – framework for inspection (March 2011) and the evaluation schedule for children's homes.

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