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

Unique reference number SC390190 Inspection date 24/07/2013 Inspector Philip Cass Type of inspection Full Provision subtype Children's home

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Date of last inspection 18/12/2012 Website: www.ofsted.gov.uk

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Brief description of the service

This is a privately operated children's home. The home is registered to accommodate up to three children with emotional and/or behavioural difficulties.

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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 inadequate .

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Overall effectiveness

Inspectors were aware prior to the inspection, that allegations had been made which identified serious safeguarding concerns. At the time of the inspection the allegations were being investigated by the appropriate external agencies. Actions taken by the setting in response to the incident were considered alongside the other evidence available at the time of the inspection to inform inspectors’ judgements.

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Overall effectiveness

Significant shortfalls in the response to child protection concerns, and shortfalls in medication arrangements, mean that the home is graded as inadequate. The home is required to ensure that it makes proper provision for the welfare of young people, adheres to agreed safeguarding procedures, seeks guidance from health professionals if a young person is injured during restraint, administers medication as prescribed, and adheres fully to its own fire risk assessment. The home is also required to ensure that all staff who begin work in the home undertake a recognised induction programme. It is recommended that staff undertake a level three qualification within six months of confirmation of employment.

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Overall effectiveness

There are areas of strong practice in the home. The home’s strengths lie in the way young people are supported to engage positively with each other. Young people make good progress in developing improved social skills and overcoming entrenched patterns of challenging and damaging behaviour. Young people are well supported to manage mental and emotional health conditions. The home is also good at providing stimulating and enriching activities. Young people are given good support to prepare for independence and adulthood.

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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 all staff receive appropriate training. This is with particular regard to the completion of recognised induction training (Regulation 27 (4)(a)) 30/08/2013

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Reg. Requirement Due date

(2001) ensure that each child has access to such medical treatment and other services as may be required (Regulation 20 (2) (b)) 30/08/2013

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Reg. Requirement Due date

(2001) take adequate precautions against the risk of fire, with particular regard to ensuring that fire doors are able to prevent the spread of fire (regulation 32 (1) (a)) 30/08/2013

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Reg. Requirement Due date

(2001) ensure that suitable arrangements are made for the recording, handling, safekeeping, safe administration and disposal of any medicines received into the children's home (Regulation 21(1)) 30/08/2013

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Reg. Requirement Due date

(2001) ensure that the children’s home is conducted so as to promote and make proper provision for the welfare of children accommodated there (Regulation 11 (1)(a)) 30/08/2013

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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 all new staff are to hold the level 3 Children & Young People’s Workforce Diploma which must include mandatory social care units; or be working towards the Diploma within 6 months of confirmation of employment (NMS 18.5)

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Outcomes for children and young people

Outcomes for young people are adequate .

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Outcomes for children and young people

Some young people make good progress at school and have very high levels of attendance. They take great pride in their achievements. The home is good at celebrating these achievements with young people. However, some young people have consistently poor educational attendance and consequently are not achieving in line with expectations. Where education attendance is poor the home works diligently with education providers to identify and address barriers to educational success. Progress has been made in tailoring education arrangements to the needs of young people. Although the home works hard to encourage young people aged 16 and over to attend and achieve in further education, there has been limited success. Young people are well supported to learn age appropriate self-care and independence skills. Young people enjoy helping out in the home by cooking, looking after their bedrooms, and helping with the shopping. As young people mature, they

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Outcomes for children and young people

are given greater independence and begin to learn a range of skills that prepare them for a successful transition to independence. The home has a clear and well- structured programme to provide young people with the skills they will require for independence. This includes household management and budgeting skills. Aftercare workers confirm that the home supports young people effectively.

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Outcomes for children and young people

Over time, young people develop improved social skills. They become better able to regulate their emotional responses, and better able to cope with setbacks. Because they grow in emotional resilience they demonstrate improved behaviours. Improved social skills enable young people take part in a range of activities and contribute to their community. This helps young people to grow in confidence and self-esteem. Because young people are encouraged to join local clubs and groups, they are able to develop a wider circle of friends in the community. Because the home makes good use of restorative justice to avoid unnecessary criminalisation of young people and they are enabled to move into adulthood without a criminal record. This significantly increases life chances.

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Outcomes for children and young people

Young people are encouraged to lead healthy lifestyles. Consequently they understand how to be healthy and make positive health choices. The home effectively shields young people from contact with drugs, alcohol and tobacco. Consequently, no young people engage in these harmful behaviours. Because staff understand the emotional and mental health conditions of each young person, these health conditions are managed effectively.

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Quality of care

Young people do not always have their behaviours and welfare needs positively addressed by staff. Inspectors were aware that serious allegations about the conduct of staff towards young people are subject to on-going child protection investigation.

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Quality of care

However, observations during the inspection indicate that staff usually engage with young people in an enthusiastic, positive manner. The home is good at supporting young people to build and maintain sound relationships with each other. Young people with a history of poor peer relationships are helped to learn social skills. This enables them to interact appropriately and build friendships. Young people describe staff as ‘brilliant’ and ‘the best’. Staff talk fluently about the care needs of each young person. Social workers report that the home meets the needs of young people, ‘in a positive way’.

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Quality of care

The home is proactive in ensuring that it has access to up-to-date care plans. Managers communicate effectively with social workers to ensure that plans are accurate and adhered to fully. The home uses referral information well to generate its own placement plans. Placement plans take account of the broad range of needs presented by young people. A separate equality and diversity plan identifies needs that relate to culture, religion, sexuality or individual preference. These needs are fully addressed in care arrangements.

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Quality of care

Young people are supported to attend all planned medical appointments. Where young people have anxieties that make them reluctant to engage with health care professionals, the home is good at helping young people to overcome their fears. Good links with mental health services mean that young people are well supported to manage emotional and mental health issues. In addition, the home is good at accessing support and guidance from health professionals if young people have health needs linked to existing conditions.

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Quality of care

However, when medication is prescribed for young people, the home does not administer this medication as directed. As a result, the health of young people is not fully promoted. When young people decline medication or refuse to take prescribed medication, the home does not consult with health professionals to evaluate the potential impact to the health of young people. Consequently alternative treatments are not identified and the young people are not provided with information that may encourage them to take their medication. Where medication is not used, the home does not dispose of this medication in line with policy. The failure to dispose of unused medication increases the risk of errors in the administration of medication.

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Quality of care

The home ensures that a wide range of stimulating and engaging activities are available for young people. Each young person has an activity planner that they are actively involved in preparing. As a result, young people report that they are excited and enthusiastic about their summer holiday plans. The programme of activities supports young people to develop talents and engage positively in the community. Meal times are used well to engage with young people. Young people say they enjoy the food very much. They look forward to meal times which are lively, social occasions.

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Safeguarding children and young people

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

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Safeguarding children and young people

Young people report that they feel safe in the home, and trust staff to do all that they can to keep them safe. However, in responding to concerns or suspicions of abuse, staff do not always act in accordance with the home’s safeguarding policies and procedures. Concerns are not immediately notified to managers in line with policy. This means that decisions about safeguarding children cannot be made in a timely manner. In addition, where there are concerns that a young person may have been harmed as a result of the actions of staff, medical attention from health care professionals is not always sought, or offered. This means that the well-being of young people is not fully promoted, and limits the information available to investigating agencies. In general, staff are empathetic to the underlying causes of challenging behaviour. Managers encourage the use of non-punitive behaviour management strategies.

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Safeguarding children and young people

Consequently the use of sanctions and physical intervention is minimal. This promotes the well-being of young people. Because young people do not go missing from the home, their risk of exploitation or abuse is significantly reduced.

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Safeguarding children and young people

The home is good at responding to incidents of bullying. Young people who have experienced significant bullying in previous placements say that they feel safer as a result of moving to the home. Where there are incidents of bullying, the home takes decisive and effective action to tackle the problem and prevent further incidents. By ensuring that young people are not subject to on-going bullying, the safety of young people is promoted.

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Safeguarding children and young people

Safeguarding systems are underpinned by careful and robust recruitment systems. Pre-recruitment checks include careful scrutiny of references, and criminal record checks. Because all staff working at the home are carefully vetted, the risk of unsuitable adults gaining access to the home is reduced.

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Safeguarding children and young people

Periodic testing of heating and electrical systems ensures that the risks to young people and staff are minimised. Fire checks are completed regularly and fire equipment is suitably maintained and serviced. Regular fire drills ensure that young people know what to do in the event of a fire. However, by wedging open fire doors in unoccupied rooms, the home does not adhere to its own fire risk assessment. This undermines the effectiveness of fire doors and reduces the safety of young people. Immediate action to address this shortfall was taken during the inspection.

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Leadership and management

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

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Leadership and management

The leadership and management of this home has failed to ensure that young people are fully safeguarded, or that action is taken promptly when child protection concerns arise. When reacting to concerns of potentially harmful staff practice, managers do not act in accordance with agreed safeguarding procedures. The Registered Manager has shared inappropriate information with staff members who are subject to investigation. This could hamper any further investigations. Unnecessary interviews are conducted with young people, without prior agreement from safeguarding agencies. This could reduce the effectiveness of actions taken by investigating agencies.

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Leadership and management

The Registered Manager and the organisation have failed to ensure that safeguarding policies are current and clearly understood by staff. The manager and staff are hindered in their efforts to adhere to policy because several versions of safeguarding policies are available in the home, some out of date. Although current policies were provided to the inspector by the Registered Manager during the inspection, senior managers subsequently report that some of these should not be relied upon. This lack of clarity reduces the capacity of the home to safeguard young people. Although staff undertake a range of training including safeguarding, first aid, physical intervention, and administration of medication, shortfalls were found in staff practice. As a result of a recent safeguarding concern managers took action to provide staff with refresher training. Staff also benefit from regular supervision that provides the

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Leadership and management

opportunity to discuss strategies to support young people.

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Leadership and management

A commitment to continual improvement is demonstrated through the home’s development plan. The development planning process has driven improvements in activity planning and staff support. Staff meetings are used effectively to generate suggestions to improve the service. A focus on improvement is further evidenced by the home’s action to address requirements set at the last inspection. All staff now receive an annual appraisal. An annual appraisal of practice and developmental needs promotes high quality child care practice.

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Leadership and management

However, a recommendation to ensure that all staff undertake a recognised induction into residential care has not been addressed. Staff who have been in post for more than a year have not completed the Children’s Workforce Development Council’s induction workbook. Although efforts have been made by the home to support staff to complete their induction training, this has not been effective. In addition, staff do not begin or complete a Children & Young Peoples Workforce Diploma in a timely manner. This impacts negatively on the ability of the home to ensure that staff are suitably qualified and competent to meet the needs of young people.

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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 and the evaluation schedule for the inspection of children's homes.

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