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

Unique reference number SC390190 Inspection date 26/11/2013 Inspector Tracy Murty Type of inspection Full Provision subtype Children's home

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Date of last inspection 11/09/2013 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 or young people 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 adequate .

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Overall effectiveness

Young people receive well planned and personalised care, which reflects their individualised needs. The staff team work hard to try and engage young people in education and training, with some success. Further work is needed to ensure that young people feel well prepared for their eventual move to independence and have the necessary skills to assist them in adult life.

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Overall effectiveness

Young people generally report feeling safe and that the staff team keeps them safe. There have been no reported incidents of young people going missing since the last inspection. Staff demonstrate a clear and detailed awareness of their roles and responsibilities in relation to ensuring that young people are protected from actual or potential harm at all times. Young people identify staff who they feel able to approach to discuss any concerns or worries they may have. Consistent boundaries ensure that young people feel well supported and respond positively to such approaches to their care. Recent changes to staffing and interim management arrangements within the home have now been stabilised, with young people and staff feeling more settled and positive.

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Overall effectiveness

Five requirements and six recommendations were made at the last inspection. All had been met at the time of the most recent inspection. Fire drills and evacuations now take place at regular intervals and involve young people. The home is now secure from unauthorised access. Managers have ensured that all relevant events have been notified to Ofsted in a timely manner. Reviews of quality of care provided now include consultation with young people, their parents and placing authorities. Each young person is registered with a medical practitioner. Young people are provided with sufficient storage facilities to meet their needs. There is minimal involvement with the home by the police. All allegations have been dealt with in a timely manner and provide protection to young people and support to staff. All staff have either attained or are working towards achieving relevant qualifications. Staff now receive regular supervision by either the acting manager or a senior manager

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Overall effectiveness

within the company. Information sharing with placing authorities has improved and managers have taken proactive action to engage authorities in improving information sharing.

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Overall effectiveness

Young people would benefit from more work being undertaken by staff to prepare them for their eventual move to independence. Staff have not routinely ensured that all health related appointments have been followed up for young people. Records relating to the use of restraint and incidents provide a detailed record of events, but do not consistently reflect robust management oversight and monitoring.

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Overall effectiveness

One requirement and two recommendations have been set as a result of these shortfalls.

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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 each young person has access to such medical, dental, nursing, psychological and psychiatric advice, treatment and other services, as he may require. This is with specific reference to ensuring that dental and optician appointments are routinely followed up. (Regulation 20(2)(b)) 20/12/2013

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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

 regularly monitor, in line with regulations, all records kept by the home to ensure compliance with the home's policies, to identify any concerns about specific incidents and to identify patterns and trends. Immediate action is taken to address any issues raised by this monitoring. This is with specific reference to the recording of restraints and incident logs (NMS 21.2)  ensure that young people are supported to prepare for moving to their own accommodation, develop practical skills, financial capability, knowledge and skills and know about entitlements to financial and other support after leaving care. (NMS 12.1)

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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

Young people develop in relation to having a positive self-image while living in this home. They develop in confidence and learn how to express their wishes and feelings. From their starting points, young people develop a clearer understanding and awareness of their backgrounds and develop in emotional resilience.

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Outcomes for children and young people

Young people enjoy good health. Clear and specific health plans set out individual needs and how these will be met. The staff team work positively and proactively with a range of agencies to ensure the holistic health needs of young people are considered. One looked after children's nurse praised the staff, stating: 'They are very good at trying to engage young people in meeting their own health needs.' The staff team proactively engages the support and services of mental health and specialist nursing services to ensure the complex and varied health needs of young people are met. One specialist nursing service confirmed that staff had sought their advice in an appropriate manner, and shared details of specific plans for young people. Not all routine health appointments for young people have been consistently met since the last inspection. Managers’ monitoring of the services provided has not identified this and undermines the potential outcomes for young people in relation to

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Outcomes for children and young people

their general health care needs being met.

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Outcomes for children and young people

Young people feel able to express their wishes, feelings and views with the staff team. Staff work with young people, engaging them in eliciting their views about the home on a regular basis, with some success. Monthly monitoring visits to the home by an independent visitor also include consultation with young people. Key work sessions further provide young people with an opportunity to discuss all aspects of the care provided to them and for staff to support them with identified areas of need.

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Outcomes for children and young people

Not all young people attend formal education, employment or training provisions. The staff team work hard to encourage the engagement of young people with suitable educational provision, with limited success. For those young people who will be moving on to adult services in the near future, more preparation is required to ensure that they have the necessary skills for such a move.

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Outcomes for children and young people

Young people enjoy regular and meaningful contact with family members and significant others in their lives. The staff team support young people to maintain contact with family members, in line with agreed contact plans. Family members are welcome to visit their children at the home and enjoy time in the local community with them. Staff proactively support contact arrangements and provide transport for contacts if required, and offer practical support to both young people and their families. Young people are supported by staff to engage and take part in a range of activities in the local community. These include shopping trips and visits to the local cinema.

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Quality of care

Young people enjoy positive relationships with staff and others in this home. Staff demonstrate a detailed awareness and understanding of the individual needs of each young person and how they will be met. Young people feel supported to develop their skills and increase in confidence over time. They respond well to their structured behaviour support plans, with no reported incidents of restraint since the last inspection. Young people feel supported to consider their concerning behaviours and to modify their responses to situations in a more appropriate manner.

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Quality of care

The staff team have worked positively with other agencies to ensure that their approaches to meeting the complex needs of young people remains appropriate and relevant. Engagement of a range of health services is a particular strength of this home. Consultation and regular meetings with mental health colleagues have led to young people’s improved confidence. The home has also worked positively with local neighbourhood police teams, to ensure that young people receive support and guidance at relevant times. One community support officer stated: 'This home is very self-sufficient and does not contact the police excessively or unnecessarily. The staff contact us for appropriate advice and ask us to visit to meet young people to discuss specific relevant issues.' Another police officer stated: 'The staff are very professional and any calls to me are warranted. We have a very positive working relationship with

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Quality of care

Young people know how to make a complaint and feel able to do so. Information on how to make a complaint is clearly available to young people in the home, along with access to a phone to make calls and details of relevant support agencies. There have been no reported complaints from young people since the last inspection.

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Quality of care

Staff understand the identity needs of young people in relation to their cultural backgrounds, ethnicity, and religion and ensure that those needs are met, in line with the placement plans. Staff ensure that young people have access to a range of services, in order to consider and meet their specific physical and emotional health needs.

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Quality of care

Staff demonstrate a detailed awareness of the complex needs of young people and present as confident and competent in being able to meet those needs. Young people are consulted on, in relation to menu planning and contribute their views on what meals they would like each week.

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Quality of care

Staff encourage young people to identify activities they may wish to take part in and support them to attend leisure activities and events in the local community. Young people are consulted with about things they may wish to do, which includes attending local cinemas and trips to local places of interest. Staff also support parents and extended family members to visit young people in the home and taking them out into the local community on a regular basis. The home is located in an area with easy access to a wide range of community resources. It is furnished and decorated to a good level, with young people being able to personalise their own bedrooms with staff support. Communal areas of the home provide young people with a comfortable space to relax and share meals together. Some young people have their own en-suite shower and toilet facilities, which provides them with additional privacy.

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Safeguarding children and young people

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

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Safeguarding children and young people

Young people report that they generally feel safe both within and outside of the home and that staff keep them safe from harm. Young people have a named key worker, who they meet with to discuss specific issues or needs on a regular basis. Staff encourage young people to complete weekly questionnaires, in order to elicit their views on the services provided and to comment on their relationships with the staff team.

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Safeguarding children and young people

The staff team demonstrate a detailed understanding and awareness of the complex needs of the young people living in this home. Individualised behaviour support plans identify the specific needs and issues for each young person and how staff should respond to them. They are reviewed and updated on a regular basis to ensure they continue to meet young people's needs.

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Safeguarding children and young people

Staff work closely with relevant agencies to discuss and determine strategies to support young people, which then informs plans and risk assessments. Staff identify the complex needs of young people and demonstrate a clear awareness of how those need are best met. Over time, this has led to improved coping strategies for young people, who respond positively to a structured and consistent approach by staff.

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Safeguarding children and young people

There have been no reported incidents of young people going missing from this home since the last inspection. High staffing levels ensure that young people living in the home receive support and supervision at appropriate levels. Missing from care protocols and procedures are understood and followed by the staff team, including close working with relevant police officers.

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Safeguarding children and young people

There has been no reported use of physical restraint since the last inspection. Young people generally respond positively to staff support and develop more appropriate coping mechanisms for their emotions and potentially harmful behaviours. Young people have not reported any incidents of bullying since the last inspection. Young people have access to a phone and contact numbers for support and advice agencies, should they have any concerns.

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Safeguarding children and young people

The selection and recruitment procedures in place ensure that no unsuitable persons are employed to work in this home. Any allegations against staff members are considered in a timely manner, with detailed records maintained relating to actions taken by management. Young people feel able to raise any concerns they may have and feel supported by staff at all stages of the process. Staff demonstrate a clear understanding of the relevant policies and procedures to be followed, in the event that an allegation is made and of the support they will receive.

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Leadership and management

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

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Leadership and management

The home has recently undergone some changes in relation to staffing. An interim manager has been brought in to oversee the home, with the vacant position having been successfully recruited to recently. Once in post, it is expected that an application will be made to Ofsted for the new manager to be registered. Senior managers from the organisation are also providing support to the staff team during this period of transition. The changes have not had an adverse impact on the care or welfare of young people living in the home.

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Leadership and management

Concerns and issues arising from the last inspection have been addressed by senior management and all requirements made at the last inspection have been acted upon and met. Managers understand the strengths and weaknesses of the home. The home has a development plan in place to consider the services provided and resources needed to ensure the home meets the complex needs of young people in the short and longer-term. Managers have sent a copy of the development plan to placing authorities and involved agencies, to ask for their comments and suggestions. The plan has been recently reviewed and sets realistic targets.

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Leadership and management

The home has an up-to-date Statement of Purpose which clearly sets out the aims and objectives of the service. Young people, staff and placing authorities have access to this document and are clear about its contents and the services provided by the home.

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Leadership and management

Regular monitoring and tracking of all aspects of the home is undertaken by managers on a monthly basis. Regulation 33 visitor reports are considered as part of this process and action taken to address any areas of need or concern raised from those visits. The visitor regularly seeks feedback from young people, staff and placing authorities to inform their reports. Reports from those visits are regularly sent in to Ofsted for consideration. Managers then use the information from the independent visitor's monthly reports to inform their own review and monitoring systems.

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Leadership and management

Staff receive appropriate levels of support and training to enable them to perform their work with the necessary skill and competence. Supervision arrangements are adequate and currently provided to staff by the interim manager and a senior manager from within the organisation.

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Leadership and management

The home is well maintained and provides young people with all necessary resources to meet their needs at all times. Records are clear and stored securely, but would benefit from more robust and regular management oversight. Not all records relating to incidents or physical restraint have been considered or signed off by a manager. This undermines the management oversight, monitoring and scrutiny of the services provided to young people or any action needed.

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Leadership and management

Managers have formed positive relationships with other agencies, particularly mental health services and local community police teams. This has led to improvements in the emotional well-being of some young people and a reduction in anti-social behaviour and missing from care incidents. Such agencies report positive working relationships with managers and staff in this home and improved outcomes for young people over time.

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Leadership and management

Since the last inspection, managers have ensured that all relevant significant events relating to the protection of young people have been notified to Ofsted. Managers have taken prompt action to address any concerns or issues raised and ensured that detailed records have been kept of all actions taken.

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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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