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

Good

The children's home provides effective services that meet the requirements for good.

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The children's home provision is good because:

 Young people’s quality of life improves significantly because they are very well cared for by staff who are passionate about their role. Highly competent managers ensure that staff fully understand the detailed care needs of each young person.

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The children's home provision is good because:

 Staff quickly recognise subtle changes in young people’s demeanour. As a result, they are pro-active in ensuring that young people, particularly those who are not mobile and cannot speak, do not experience discomfort or frustration. Because staff are so attentive to the young people, the risk of accidental injury is very low.

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The children's home provision is good because:

 The very effective management of ongoing conditions, in collaboration with parents and health professionals, leads to a significant reduction in the levels of pain experienced by young people on a day-to-day basis. Young people develop an increased range of movement, are physically stronger and have improved overall health.

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The children's home provision is good because:

 Staff are confident and highly skilled in the care of young people who experience frequent seizures or whose seizures place them at risk of injury.

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The children's home provision is good because:

 Young people enjoy a good range of activities, both in the home and the community. The staff ensure that complex physical and learning difficulties do not prevent young people from leading full, active, and stimulating lives.

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The children's home provision is good because:

 Family contact and visiting arrangements are good. The home recognises the positive impact that family contact has on young people. As a result, they place very few limitations on family visits. Managers consult carefully with parents before implementing any changes to care arrangements.

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The children's home provision is good because:

 Safeguarding systems are very effective. The open and transparent approach adopted by the home significantly reduces the risk of abuse.

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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 (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. The registered person(s) must comply with the given timescales.

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Requirement Due date

5. The engaging with the wider system to ensure children’s needs are met standard In meeting the quality standards, the registered person must, and must ensure that staff— (b) seek to secure the input and services required to meet each child’s needs; and (d) seek to develop and maintain effective professional relationships with such persons, bodies or organisations as the registered person considers appropriate having regard to the range of needs of children for whom it is intended that the children’s home is to provide care and accommodation. 07/09/2015

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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

 The registered person should ensure that skills in safeguarding, specifically relating to young people with learning difficulties, are gained, refreshed and recorded in the home’s workforce plan. (The Guide to the Quality Standards, page 43, paragraph 9.12)

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Recommendations

 All staff must have their performance and fitness to carry out their role formally appraised at least once annually. This appraisal should take into account, where reasonable and practical, the views of other professionals who have worked with the staff member over the year and children in the home's care. (The Guide to the Quality Standards, page 61, paragraph 13.5)

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Information about this children's home

This privately owned home is registered to provide care and accommodation for up to five children and young people with learning disabilities and physical disabilities.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

22/01/2015 CH - Interim Improved effectiveness

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good

The day-to-day experience of each young person in the home is good. Staff engage with young people very well. They say that, ‘we love working here’. Their enjoyment of their role contributes to their high quality interactions. For example, they use their tone of voice very well to communicate considerable warmth and affection to young people who have limited comprehension. Staff give young people their full attention when undertaking personal care tasks such as feeding and dressing. They are acutely aware of subtle changes in the presenting behaviours of young people that might indicate pain, discomfort or frustration. Consequently, they ensure that young people are comfortable, contented and stimulated. Staff take pride in their ability to recognise the wishes of young people who are unable to speak. For example, they know when one young person wants to alter his position by the particular noise he makes, and recognise a specific

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good

movement of another to be a request for a drink. Staff also take time to identify which toys young people like to play with, their preferred foods, and favourite television shows. Care plans are updated frequently to reflect the expressed wishes of young people.

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good

Health outcomes are strong. Each young person receives healthcare that improves their quality of life. Specifically, they experience less pain, discomfort and frustration while enjoying a greater range of movement and improved sensory experiences. The attentiveness of staff is key to the effective management of complex health conditions. Many young people experience frequent seizures. Staff are highly skilled in their response, keeping careful records so that medical specialists are able to make informed decisions about treatment programmes. Healthcare arrangements are further strengthened by improved medication systems. These greatly reduce the potential for administration errors.

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good

There are several examples of staff working well with a range of healthcare professionals and acting as strong advocates when care plans require improvement. For example, they engaged positively with nurses to ensure that arrangements to transfer a young person from hospital to the home were carefully thought through and appropriately risk assessed. However, potential opportunities to improve the quality of life for young people are not always taken. The home is not always sufficiently assertive in questioning decisions made by healthcare professionals or making suggestions that might improve the day-to-day experience of young people, particularly in relation to optician check-ups.

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good

The home ensures that learning and physical disability are not a barrier to participation in stimulating, fun activities. Young people lead active lives. They make good use of the large stock of indoor and outdoor play equipment, including a newly installed wheelchair accessible swing. They engage fully in their communities, including going to restaurants, cafés, parks, the cinema, and concerts. Managers also provide young people with the opportunity to go on holiday each year. Great care has been taken to ensure that the hotel accommodation chosen for this year’s holiday has suitable bathing facilities and hoisting equipment.

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good

Education is also very well supported by the home. Managers understand each young person’s education entitlement and advocate well to ensure that they are provided with full time, individually tailored, learning programmes. Transport arrangements are carefully co-ordinated so that, where the health of young people allows, they attend community schools each day. They make considerable progress at school. For example, one young person was awarded ‘student of the year’ for his achievements. The opportunity to attend school every day ensures that young people can interact socially with their peers, and have access to specialist facilities such as a hydro-pool.

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good

Young people benefit from a pleasant home environment that is well decorated and well furnished. High standards of cleanliness contribute to the home’s welcoming feel. The home’s spacious grounds are well used to host garden parties for young people, their family, friends, teachers, and social workers. This demonstrates the home’s commitment to ensuring that family and community relationships are maintained while young people are accommodated at the home.

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good

Where young people are able to express their views and wishes, managers are very quick to respond. For example, transition arrangements for a young person moving into adult care arrangements were significantly altered to reflect his expressed wishes. The home challenged social workers and independent reviewing officers on his behalf to ensure that his stated preferences were central to decision making. The home goes to considerable lengths to identify and address individual needs that stem from the culture and background of young people. For example, a young person of Eastern European heritage has been bought a tablet computer on which a variety of Latvian music, films and cartoons have been saved. Staff have also taken time to learn a number of Latvian words and phrases and to use these each day when undertaking personal care tasks. Judgement grade

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Good

Young people are well protected from abuse and exploitation because the home adopts an open and transparent approach to safeguarding. Where parents or external professionals raise any concerns, the home provides a prompt and effective response. Established relationships with local authority safeguarding teams mean that all relevant information is shared quickly. This enables thorough investigation. Diligent recording of unexplained injuries also supports prompt investigation. Managers are working to further strengthen the way young people are protected by challenging social workers to ensure that each young person has access to suitable independent advocates.

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Good

Both staff and managers have a very strong understanding of the particular vulnerabilities of young people with disabilities, especially those with limited verbal communication. All staff have the skills to identify and act upon signs that a child is at risk of harm, because they attend safeguarding training. Some staff have also undertaken specific learning difficulties safeguarding training. This enhances their ability to protect the particularly vulnerable young people they care for. However, the majority of staff have not yet attended this training.

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Good

The management of challenging and potentially harmful behaviour is strong. Staff fully understand and adhere to well-written individual behaviour management plans. As a result, young people are well supported to behave safely. Well- established routines mean that young people experience consistency of care, and that anxieties generated by change are reduced. Restraint is used infrequently, and appropriately, when necessary to keep young people safe or prevent injury to staff or members of the public. Because staff are well trained in the safe handling of young people, they minimise the risk of injury or trauma occurring as a result of restraint. Careful scrutiny of restraint practice is supported by good quality record keeping.

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Good

Young people are very closely supervised. This significantly reduces the risk of accidental injury. All areas of the home and individual activities are routinely checked to ensure that potential hazards are removed or minimised. Individual evacuation plans, reflecting the learning and physical disability of each young person, ensure that young people can be kept safe in the event of fire. Staff demonstrate a very clear understanding of how to use potentially dangerous equipment such as hoists and wheelchair lifts. Great care is taken in the moving and handling of young people who are vulnerable to accidental injury. For example, staff undertake a series of additional checks prior to moving a young person with brittle bones to ensure that he is secure and comfortable in his wheelchair.

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Good

Complex health conditions make current residents particularly vulnerable to bacterial infection such as MRSA. The home’s detailed risk assessments, combined with clear guidance provided to staff, mean that highly effective infection control systems are in place. Where young people develop infections during treatment at hospital, these quickly clear when they return to the home.

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Good

The experienced and competent registered manager has been in post for three years. During this time she has driven significant improvement in the management of the home. Managers and staff are able to demonstrate the progress that young people make. They actively monitor care planning processes, intervening where necessary to encourage the adoption of new strategies or suggesting the involvement of other specialist agencies. She has clear and realistic improvement objectives that are focused on enhancing the daily experience of young people. The registered manager’s ‘continual improvement plan’ is a useful tool in measuring progress towards achieving the stated objectives of the home. Good progress is being made towards current objectives such as the development of a new sensory play area. The manager is good at motivating the staff team to come up with suggestions to improve the experience of young people. For instance, staff

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Good

have recognised that admission to the home can generate considerable anxieties for young people. As a result, they recently produced a DVD, showing the resources available in the home and introducing staff, which can be shown to potential new admissions.

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Good

The registered manager is suitably qualified, having completed the Level 5 Diploma in Leadership and Management for Residential Childcare in 2014. She is focused on increasing the proportion of staff who hold a relevant qualification in residential childcare. More than half of the staff team have completed their Level 3 Diploma since the last inspection. Consequently, the home is better able to demonstrate that young people are cared for by a knowledgeable and well-qualified staff team. Staff also benefit from a broad range of training which enables them to meet the complex social, health, and care needs of young people. Good use is also made of staff meetings, supervision, and informal mentoring to ensure that staff have a detailed understanding of care plans, risk assessments and behaviour management strategies. Where staff require additional support to meet the high standards expected by the registered manager, performance management systems are used

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Good

appropriately to promote improvement. However, an administrative oversight has meant that good use is not currently made of the home’s appraisal processes to develop and improve staff performance.

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Good

Staff say that they are well managed and find the management team to be, ‘very good and supportive’. As staff become better qualified, trained and supported, they grow in confidence. The registered manager encourages staff to be assertive in their interactions with other agencies, including health providers, social workers, and schools. As a result, the home is able to provide several examples of how it develops effective partnerships with other agencies involved in the care of residents. However, there are some occasions where the quality of partnership working is not good. Managers and staff are occasionally not afforded the professional respect to which they are entitled. The welfare and well-being of young people are not promoted fully because staff at the home, who have expert knowledge of the needs and wishes of young people, are sometimes not invited to contribute to decision-making forums. Some key information is not shared with the

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Good

home at all, while other information is not shared promptly. Managers are not sufficiently assertive in challenging partner agencies who do not work collaboratively in the best interests of young people.

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Good

Management monitoring of the home is of a good standard. The registered manager carries out detailed evaluations of all practice and is good at recognising areas of potential improvement. An independent visitor is commissioned to conduct a detailed audit of the home each month. Suggestions made by the visitor have prompted managers to seek independent advocates for young people, and improved care planning. External scrutiny is invited from a range of stakeholders including social workers, teachers and parents, who are encouraged to visit, ask questions about care arrangements, and contribute to decision making in the home. External scrutiny of medication administration systems by a pharmacist also demonstrates the commitment of the home to providing safe care to young people. This very transparent approach provides reassurance to placing authorities that care standards are consistently high.

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What the inspection judgements mean

The experiences and progress of children and young people are at the centre of the inspection. Inspectors will use their professional judgement to determine the weight and significance of their findings in this respect. The judgements included in the report are made against Inspection of children's homes: framework for inspection.

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What the inspection judgements mean

An outstanding children's home provides highly effective services that contribute to significantly improved outcomes for children and young people who need help and protection and care. Their progress exceeds expectations and is sustained over time. A good children's home provides effective services that help, protect and care for children and young people and have their welfare safeguarded and promoted. In a children's home that requires improvement , there are no widespread or serious failures that create or leave children being harmed or at risk of harm. The welfare of looked after children is safeguarded and promoted. Minimum requirements are in place, however, the children's home is not yet delivering good protection, help and care for children and young people. A children's home that is inadequate is providing services where there are widespread or serious failures that create or leave children and young people being

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What the inspection judgements mean

harmed or at risk of harm or result in children looked after not having their welfare safeguarded and promoted.

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people living in the children's home. Inspectors considered the quality of work and the difference adults make to the lives of children and young people. They read case files, watched how professional staff work with children, young people and each other and discussed the effectiveness of help and care given to children and young people. Wherever possible, they talked to children, young people and their families. In addition the inspectors have tried to understand what the children's home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people who it is trying to help, protect and look after. This 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 Children's

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Information about this inspection

Homes (England) Regulations 2015 and the Guide to the children's homes regulations including the quality standards. the guidance raising concerns and making complaints about Ofsted, which is available from Ofsted's website: www.gov.uk/government/organisations/ofsted . If you would like Ofsted to send you a copy of the guidance, please telephone 0300123 4234, or email enquiries@ofsted.gov.uk .

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Information about this inspection

achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children's social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, workbased learning and skills training, adult and community learning, and education and training in prisons and other secure establishments. It inspects services for looked after children and child protection. If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 4234, or email enquiries@ofsted.gov.uk . You may reuse this information (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence. To view this licence, visit www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team,

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Information about this inspection

The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

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Information about this inspection

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Information about this inspection

Store Street Manchester M1 2WD T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: www.gov.uk/government/organisations/ofsted

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