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

Unique reference number SC390190 Inspector Philip Cass Type of inspection Full Provision subtype Children's home

p.1

Registered person Pathway Care Solutions II Limited Registered person address 14 Regent Street NOTTINGHAM NG1 5BQ

p.1

Responsible individual Ameer Rehman Registered manager Gerald Lloyd Gordon Date of last inspection 26/11/2013 2 of 9 Inspection date 08/07/2014

p.1

Previous inspection adequate Enforcement action since last inspection No enforcement action has taken place since the last inspection

p.2

Overall effectiveness good

Outcomes for children and young people good Quality of care good Keeping children and young people safe good Leadership and management good

p.2

Overall effectiveness

The home provides a safe, nurturing environment for children and young people to grow and develop. Children and young people interact in a caring, supportive manner with each other. They also enjoy positive, trusting relationships with staff. As a result they grow in self-confidence and self-esteem during their time at the home.

p.2

Overall effectiveness

The home is good at managing complex health conditions. Staff receive good quality training and support so that they effectively monitor and manage health issues. As a result, children and young people have improved health outcomes. Children and young people also make good educational progress. They develop more stable routines that promote attendance and learning.

p.2

Overall effectiveness

The recently appointed manager has quickly identified ways to improve practice in the home. Several key improvements have taken place since the last inspection. Because staff in the home have a clear understanding of safeguarding systems and procedures, residents are safer. Staff are also working more effectively as a team. This improves the consistency of care provided.

p.2

Overall effectiveness

The manager has been asked to ensure that all staff fully understand the home’s 3 of 9 policy on self-administration of medication and understand what responsibilities are delegated to them in this regard. 4 of 9

p.2

Information about this children’s home

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.

p.4

Inspection date Inspection type Inspection judgement

26/11/2013 Full adequate 11/09/2013 Full inadequate 24/07/2013 Full inadequate 18/12/2012 Interim good progress

p.4

Recommendations

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

p.4

Recommendations

 ensure that staff are clear about what responsibilities and decisions are delega to them and where consent for medical treatment needs to be obtained. (NMS 6.5) 5 of 9

p.4

Outcomes for children and young people good

Education outcomes are strong. Attendance improves following admission to the home because children and young people are well supported to overcome long- standing barriers to attendance. Good quality further education provision is identified and agreed for the next academic year. The home works effectively with specialist education providers to manage, and gradually reduce, levels of challenging behaviour. Staff work well with local education providers to identify more appropriate placements when schools feel they are unable to meet the needs of children and young people placed at the home. This ensures that emotional and behavioural difficulties do not disrupt educational progress unnecessarily.

p.5

Outcomes for children and young people good

Children and young people make good progress in relation to their health. They trust staff to offer appropriate health advice. This enables them to make positive, informed health choices. In addition, children and young people are given good support to understand and manage existing health conditions. Health outcomes are also improved because children and young people adopt healthier lifestyles following admission to the home. For example, they state that they are pleased to be taking more regular exercise.

p.5

Outcomes for children and young people good

Children and young people’s emotional well-being and self-view is considerably improved during their time at the home. They feel supported and valued by staff. As a result, they quickly form trusting relationships. As children and young people develop improved social skills, they grow in self-confidence. Self-esteem is also promoted because they contribute positively to their home and community. Children and young people are encouraged to participate in all decisions that may affect them. They are also well supported to participate in community events and use local facilities. This leads to improved social skills and provides opportunities to form friendships.

p.5

Quality of care good

Children and young people benefit from a well decorated and presented home environment. Bedrooms are recently refurbished. This allows residents to take pride in their environment and enjoy nurturing private spaces. Care planning is of a good standard. This ensures that effective plans are in place to meet the developing needs of children and young people. Care plans support staff to identify and address needs that stem from the culture, background, and age of young people effectively.

p.5

Quality of care good

Admission planning is robust and is focused on carefully matching admissions to the home with the age and vulnerability of existing residents. This contributes towards 6 of 9 the settled, welcoming atmosphere in the home. Most interactions are supportive and nurturing. Children and young people report that, ‘we look after each other here’. Staff are good at balancing the needs of older and younger children. They help older residents to act as positive role models and reward them for setting a good example.

p.5

Quality of care good

Children and young people also enjoy sound relationships with staff. The group of staff who provide care in the home is becoming increasingly consistent. Young people are helped to develop trusting relationships because there is minimal use of staff that children and young people are not familiar with. Staff demonstrate a good understanding of the underlying causes of challenging behaviour. They respond with considerable care and empathy when children and young people are not able to manage their emotional responses. Staff display great sensitivity when helping residents to understand why it is not possible to act upon their wishes in all cases. Positive behaviour is rewarded by enabling greater independence and involvement in decision making. This helps children and young people to take responsibility for their own behaviours.

p.6

Quality of care good

Staff are good at supporting children and young people with complex emotional and physical health needs. Specialist training enables staff to understand and address existing conditions. Training is also effective in ensuring that staff respond well during health crisis or emergency. Because children and young people are secure in the knowledge that staff know how to help them when they are unwell, they have less anxiety. Medication administration systems are safe because staff ensure that prescribed medication is given in the correct dosage and at the right times. However, not all staff are clear about what responsibilities and decisions are delegated to them in relation to self-administration of medication. This has resulted in some unnecessary delay in responding to requests to self-administer.

p.6

Quality of care good

Children and young people make constructive use of their time and take part in a wide range of leisure activities. Staff are good at facilitating play activities for children. They display high levels of energy to match the demands of younger residents. Because they engage in play activities enthusiastically, children have fun while developing improved social and communication skills.

p.6

Keeping children and young people safe good

Children and young people are safe in the home. Managers and staff have a good understanding of how to respond to allegations or concerns of potentially abusive practice. This means that any concerns are addressed promptly and effectively. The safety of children and young people is promoted because safeguarding systems are of a good quality. The risk of unsuitable adults gaining access to the home is reduced by robust vetting of all staff before they begin work in the home. This vetting includes telephone verification of references and enhanced criminal record checks.

p.6

Keeping children and young people safe good

Effective behaviour management strategies mean that there are few incidents of 7 of 9 challenging behaviour in the home. Physical intervention is used very sensitively to ensure that accidental injury is avoided. The likelihood of inappropriate restraint is reduced by robust management evaluation and external monitoring of restraint practice. Because record keeping is significantly improved, the monitoring of restraint is more effective. There are no incidents of bullying. This means that children and young people feel safe and secure in their home.

p.6

Keeping children and young people safe good

Staff understand and fully adhere to the home’s risk management systems. Risk assessments are clear and proportionate. This means that activities are safe and stimulating. The home’s fire risk assessment is fully adhered to. Regular fire drills ensure that children and young people know how to safely evacuate in the event of an emergency. External professionals regularly undertake checks of gas and electrical installations. This further reduces the risk of accidental injury.

p.7

Keeping children and young people safe good

Safety is also improved because children and young people rarely go missing from the home. During periods of unauthorised absence staff are diligent in their efforts to ensure a quick and safe return to the home. Because the staff establish effective working relationships with family members, police and safeguarding agencies, children and young people receive more consistent messages about the risks associated with unauthorised absence.

p.7

Leadership and management good

The Registered Manager has been in post for nine months. He is suitably experienced and knowledgeable, but not yet qualified. However, he is undertaking the appropriate qualification within agreed timescales. The Registered Manager feels well supported by senior managers within the organisation. Recent changes to quality assurance systems better support him to identify areas of potential development. Improvement is further promoted by the homes good quality development plan. This has improved care planning, recording, activities, and consultation.

p.7

Leadership and management good

One requirement and two recommendations were set at the previous inspection. These have all been addressed by the new management team. Consequently, young people are better supported when preparing for transitions from the home and have improved access to a broad range of health services. In addition, the improved recording of incidents enables more effective monitoring to take place. Consequently, the risk of abuse is reduced.

p.7

Leadership and management good

The Registered Manager communicates high expectations to staff by the effective use of staff meetings, appraisal and supervision. The staff team respect his commitment to the home and value the fact that he is approachable and supportive. Staff note that the management style adopted in the home has helped them to work well as a team. This has resulted in greater consistency, better morale, and improved outcomes for young people. Where concerns over work practice arise, these are addressed openly and efficiently. As a result the home is good at learning from its 8 of 9 mistakes.

p.7

Leadership and management good

Staff receive high quality training that enables them to understand and address the complex needs of young people. Because specialist health training is provided where necessary, staff are confident that they can meet all the presenting needs of young people in the home. Managers also provide staff with additional information and guidance when young people move into the home. For example, when a younger child moved into the home managers provided a child development briefing to all staff. This refreshed their knowledge of behaviour management and supported the establishment of age-appropriate routines. Website: www.ofsted.gov.uk

p.8

Leadership and management good

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.

p.9

Judgement Description

Outstanding A service of exceptional quality that significantly exceeds minimum requirements.

p.9

Judgement Description

Good A service of high quality that exceeds minimum requirements.

p.9

Judgement Description

Adequate A service that only meets minimum requirements.

p.9

Judgement Description

Inadequate A service that does not meet minimum requirements.

p.9

Information 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.

p.9

Information 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 framework of inspection for children's homes.

p.9