Children's home run by Pathways Care Group Limited in Runnymede

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:

 Children receive highly individualised child-focused care, which has a positive impact on their lives.

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The children's home provision is good because:

 Staff provide a nurturing environment within which children’s emotional needs are well met. As a result, they flourish.

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The children's home provision is good because:

 Children are healthy and make good progress from their starting points.

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The children's home provision is good because:

 Good transition planning into adult services minimises the stress of change for vulnerable children.

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The children's home provision is good because:

 Children are safe. They are helped to feel safe through effective maintenance of the regular routines, which are important to them.

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The children's home provision is good because:

 The stimulating home environment provides children with opportunities to learn and to develop throughout the day.

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The children's home provision is good because:

 The strong commitment to children’s involvement in the home means that they feel fully included in all decisions about their lives.

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The children's home provision is good because:

 The home is well led, ensuring a shared vison of enabling children to make positive choices and to live happy fulfilling lives.

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The children's home provision is good because:

 Families and partner professionals say that the home makes a positive difference.

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The children's home provision is good because:

 This inspection identifies some areas for improvement. These are in relation to ensuring that staff are recruited in line with best practice and receive appropriate training. The manager has been asked to ensure that key documents, such as the location risk assessment and staff rota are suitably detailed and accurate.

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Statutory requirements

This section sets out the actions that must be taken so that the registered persons 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 persons must comply within the given timescales.

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Requirement Due date

The registered person must only employ an individual to work at the children’s home if full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. In particular, ensure a full employment history, together with a satisfactory explanation of any gaps in employment and ensure that suitable references are obtained and a copy of any relevant qualification is held. Furthermore, document the decision-making process when employing staff and when information that has the potential to impact on their suitability is established (Regulation 32(3)(d), Schedule 2(2)(6)). 18/07/2016

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Requirement Due date

The registered person must ensure that an individual who works in the home in a care role has the appropriate qualification, the level 3 diploma in residential childcare (England) (‘the level 3 Diploma’) or a qualification which the registered person considers to be equivalent to the level 3 diploma by the relevant date which in the case of an individual who was working in a care role in a home on 1 April 2014, is 1 April 2016 (Regulation 32(3) (b)(4)(a)(b)(5)(b)). 31/08/2016

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Requirement Due date

The registered person must ensure that all employees undertake appropriate continuing professional development. In particular, ensure that all staff complete suitable training in first aid and safeguarding children with disabilities (Regulation 33(4)(a)). 31/08/2016

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Requirement Due date

The registered person must maintain in the home the records in Schedule 4. This includes a copy of the staff duty roster of persons working at the home, and a record of the actual rosters worked; in particular, the times of each shift worked (Regulation 37(2)(a), Schedule 4(3)). 18/07/2016

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendation:  Review the appropriateness and suitability of the location and premises of the home at least once a year. The review should include the identification of any risks and opportunities presented by the home's location and strategies for managing these. Providers should refer to the non-statutory advice about the location assessment process (‘Guide to the children’s homes regulations including the quality standards’, page 64, paragraph 15.1).

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Information about this children's home

This children's home is run by a private company. The home is registered to provide a service for up to four children or young people with learning difficulties and/or emotional and behavioural difficulties.

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Recent inspection history

Inspection date Inspection type Inspection judgement

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Recent inspection history

9 February 2016 Interim Sustained effectiveness

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Recent inspection history

15 October 2015 Full Requires improvement

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Recent inspection history

17 March 2015 Interim Declined in effectiveness

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Good

The children flourish in the care of staff who know them well. Staff ensure that the routines that are important to the children are maintained and that they receive individualised care, which helps them feel to safe and secure. The children make good progress from their starting points in relation to their confidence, communication, independence and behaviour. Their cultural needs are well met in practice and children enjoy positive role models from a variety of backgrounds. Specific religious and personal care needs are well met. One young person wants to grow a ‘big afro and a beard’ and described how happy they are to be helped to meet this desire. Staff help children to manage their anxieties through visual daily schedules and social stories. As a result, their levels of obsessive and challenging behaviour have reduced, indicating that they feel calmer and more in control of their lives. One professional said, ‘I can see how settled he feels. His anxiety has reduced so much.

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Good

He is now always happy and smiling.’ One family member commented, ‘He is doing really well and is now very settled and much calmer.’ The children refer to particular members of staff, saying, ‘I like [Name]’. These are often the people who take them out to buy their favourite trainers or Lego. They describe enjoying a variety of activities, such as going running, to the cafe or cinema. Older children particularly enjoy their visits to a local restaurant where they describe choosing their favourite spicy chicken. These positive relationships help the children who have autistic spectrum disorder to develop their resilience and a strong sense of permanence and belonging. The staff ensure that children maintain optimum health through effective primary health checks. Staff work hard to help children to understand the importance of these and to support them through their extreme levels of anxiety though the use

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Good

of social stories. One child has made significant improvement in their health, moving towards receiving all nutrition orally rather than via a pump feed. Staff undertaking medication or complex care tasks are trained and their competence is periodically reassessed. However, a number of staff have not received suitable practical first-aid training. This is of particular concern, given that some children have epilepsy. The children have 100% school attendance, missing school only when ill, and they are individually making good progress. The effective communication between home and school ensures a consistent approach, which is particularly important due to the complex needs of the children. Staff provide a learning environment with a variety of activities, ensuring that the children remain consistently and appropriately stimulated. For example, the children are encouraged to make use of the sensory boards and technical applications on their tablet computers, to explore

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Good

the world around them as well as to communicate with people. One teacher said, ‘They are always taking him out doing things.’ Inclusion is central to the philosophy of care, and staff constantly seek children’s thoughts, wishes and feelings through direct discussion and observation of their non-verbal communication. Staff are committed to helping children to make decisions and choices about their lives at levels that are appropriate to them. Pictorial communication regimes are threaded through the service and are actively used by children to understand their environment and the planned activities. On occasion, they replace disliked activity symbols, such as a haircut, with ones that they would prefer. Photographs help children to share and remember memorable moments, such as dressing up as a superhero or eating an ice cream. The children are encouraged to develop appropriate new skills that help them to

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Good

progress. One spoke with pride about how they have learnt to go to the shop on their own to buy food to cook for dinner. Staff helped them to do this gradually, step by step, and continue to assist, preparing a short pictorial shopping list. Staff develop positive relationships with parents and professionals, ensuring that children receive the individualised care that they need. Family relationships and contact are well supported, ensuring that these key figures remain fundamental in their lives. Families rate the home as ‘good’ to ‘brilliant’ and one parent said, ‘I’m happy with the home, which is very good in lots of ways.’ Good-quality assessments and care planning systems provide staff with effective guidance on how to meet children’s individual complex needs. Well-planned transition arrangements mean that children moving into adult services move to a new home that is suitably prepared to meet their needs.

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Good

Staff vetting procedures are not sufficiently robust to ensure that young people are fully safeguarded from unsuitable people gaining employment in the home. For example, on occasion, references are not named, signed and dated; short gaps in employment are not documented as explored; or, where information identified has a potential bearing on suitability, the exploration of this with the applicant is not documented. This means that there is insufficient documented scrutiny of applicants’ employment history and character. A number of staff have yet to complete the basic e-learning safeguarding training, and only one has undertaken training that addresses safeguarding children with disabilities. This is of concern, particularly given the level of communication and disabilities that these children have. Staff are clear about their duty to report any concerns to the manager, having been advised of basic safeguarding and whistle-

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Good

blowing procedures, but are unaware of the wider selection of professionals independent of the home to whom they can report any concerns. The impact is reduced, because, in practice, the manager has shown vigilance, ensuring that any concerns or potential safeguarding issues are well managed with partner agencies in an open and transparent manner. Suitably detailed risk assessments ensure that risks are identified and understood. These are regularly updated and effectively shared among the team members, enabling staff to be successful in effectively managing risk to promote children’s development. For example, staff have very clear risk assessments and guidelines in place to facilitate and support a child to travel to a local shop independently. Thresholds for physical restraint are clear, and no inappropriate interventions or sanctions are used. Staff have received training in restraint since the last

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Good

inspection, which means that staff are now confident and competent to use this appropriately. The level of restraint has substantially reduced in the past six months, and now most physical interventions are breakaway techniques. The ethos of behaviour management has completely changed in the past six months. The use of sanctions is now rare, and children are given immediate rewards and praise for positive behaviour. Staff have undertaken training in autistic spectrum disorder, which has helped them to begin to understand what is communicated by each child’s behaviour. For example, one child is now encouraged to stamp to show anger, which has almost eliminated the hitting of staff. This has then been progressed in the house to stamping on a sensory mat. This distracts them, helping them to let go of their anger once expressed. Consistent support and routines that reflect children’s individual needs help to

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Good

reduce any anxieties. As a result, most reduce their challenging behaviours significantly. For example, six months ago, one child was restrained 11 times in one month. This child has had no restraints in the past three months. The building is suitable to meet the needs of the young people. Health and safety arrangements are well managed with regular servicing of equipment and suitable fire prevention measures in place. Appropriate security and supervision arrangements mean there have been no incidents of children going missing. Nor have there been any safeguarding concerns in the home. Professionals and families say that they have absolute confidence in the staff to keep their children safe. One said, ‘I have a real sense that he feels well cared for and safe.’ Another said, ‘He has lots of different staff that make him feel safe. I’m gutted he has to leave.’ Children, when talking about the home, simply say, ‘I like

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Good

This is the manager’s first management role and they have been in post for nine months. They do not yet hold a suitable level 5 qualification. However, there are clear plans in place to achieve this in line with regulation. The manager, working closely with their deputy, has successfully brought about a change in ethos in the home, working towards implementing a ‘secure base’ model of care. They have prioritised the needs of the children and improved the quality of support provided to children and staff. The effective monitoring systems are utilised well to gain a clear sense of the strengths of the service, and, as result, they have a clear vison for developing the service, particularly in relation to communication systems and autism-friendly routines and structures. The home is suitably resourced to ensure that the service meets the aims and objectives set out in the statement of purpose. A variety of staff training is

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Good

provided in areas, such as, medication, autistic spectrum disorder awareness, and restraint. However, suitable training for staff in relation to first aid and safeguarding children who have disabilities has not been provided for a number of staff. The manager has begun to consider, but has yet to clarify, whether alternative qualifications for those staff who have worked in children’s home since April 2014 are equivalent to the level 3 diploma. Furthermore, three members of staff have yet to complete their level 3 training. Staff professional awareness and competence have the potential to be undermined when key training has not been undertaken. Staffing levels are appropriate, and staffing changes have reduced in recent months providing improved consistency and stability for the children. Staff feel well supported though effective induction process supervision and appraisal. Staff say that they work well together as a team and describe being led well by a very

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Good

‘hands-on’ manager. Staff enjoy working at the home, and young people benefit from their enthusiasm. Professionals and families refer to staff who are ‘fantastic’ and ‘ very caring’. The manager and staff build very strong partnership working with parents and professionals, which ensures that the best possible all-round support is provided. The children make good individual progress in relation to their behaviour, confidence, communication and personal skills. The manager is not hesitant to challenge placing authorities, for example, when they feel that the young person has outgrown the service. One partner professional said, ‘It’s one of the best places I’ve worked with,’ and described their young person as having ‘blossomed’. Recording systems within the home are generally sound. However, staff rotas are not sufficiently clear to identify the actual times of each shift worked. While this has no impact on children, it is a breach of regulation and inhibits the ease of

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Good

establishing which members of staff are on site at any given time. The manager provides good-quality notifications of all significant events to the relevant authorities and takes appropriate action following any incident. The manager has undertaken a review as to the appropriateness and suitability of the location and premises of the home. This identifies low risks in relation to criminal activity within the community. However, there is insufficient information or evaluation of any risks and opportunities regarding health, or strategies for managing these. The manager has been proactive in improving all areas highlighted in previous inspections, effectively addressing the vast majority of requirements, and demonstrating a commitment to service development. Although some requirements and recommendations have been set at this inspection, these do not significantly undermine the good-quality individualised care that the children

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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 children looked after 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 that 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 that 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 whom 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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