Children's home run by Pathway Care Solutions Ltd in Nottingham

Inspection report children’s home: SC406063 1 SC406063 Registered provider: Pathway Care Solutions II Ltd

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Full inspection Inspected under the social care common inspection framework

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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 who have learning disabilities and/or physical disabilities.

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Overall experiences and progress of

children and young people, taking into account

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outstanding

How well children and young people are helped and protected good

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outstanding

The effectiveness of leaders and managers outstanding

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outstanding

The children’s home provides highly effective services that consistently exceed the standards of good. The actions of the children’s home contribute to significantly improved outcomes and positive experiences for children and young people who need help, protection and care.

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outstanding

Date of last inspection: 9 February 2017

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outstanding

Overall judgement at last inspection: Improved effectiveness Inspection report children’s home: SC406063 2

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Key findings from this inspection

This children’s home is outstanding because:

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Key findings from this inspection

 Young people make exceptional progress in a nurturing and inclusive environment.  Staff ensure that young people are fully involved in their community. Staff ensure that disability does not prevent young people from enjoying a wide range of exciting and new experiences.  Staff clearly understand the complex and varied needs of young people and, as a result, they provide excellent care and keep young people safe.  Transitions to and from the home are extremely well planned. Staff ensure that young people experience very little anxiety or distress because of changing care arrangements.  Training in safeguarding and medication is first-rate, ensuring that young people are kept as safe as possible.  The registered manager is highly effective, driving improvement and supporting her staff in the delivery of outstanding services.  Some shortfalls in the area of help and protection mean that the judgement in

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Key findings from this inspection

that area can be no more than good. However, these shortfalls do not detract from the overall outstanding progress and experiences that young people enjoy.

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Key findings from this inspection

The children’s home’s areas for development:

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Key findings from this inspection

 The manager must ensure that all plans and behaviour management strategies are consistent and provide clarity on how certain strategies protect young people.  The manager’s review of incidents and debriefs with staff should be recorded to ensure learning.  Improve the quality of recording and use of language in reports. Inspection report children’s home: SC406063 3

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Inspection date Inspection type Inspection judgement

09/02/2017 Interim Improved effectiveness 17/11/2016 Full Outstanding 25/02/2016 Interim Improved effectiveness 29/07/2015 Full Good Inspection report children’s home: SC406063 4

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Statutory requirement

This section sets out the actions that the registered person(s) must take to meet 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 within the given timescales.

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Requirement Due date

The registered person must prepare and implement a policy (‘the behaviour management policy’) which sets out the measures of control, discipline and restraint which may be used in relation to children in the home. (Regulation 35(1)(b)) 06/10/2017

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Recommendations

 Records of restraint must be kept and should enable the registered person and staff to review the use of control, discipline and restraint to identify effective practice and respond promptly where any issues or trends of concern emerge. (‘Guide to the children’s homes regulations including the quality standards’, page 49, paragraph 9.59)  Staff should be familiar with the home’s policies on record-keeping and understand the importance of careful, objective, and clear recording. (‘Guide to the children’s homes regulations including the quality standards’, page 62, paragraph 14.4)

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Overall experiences and progress of children and young people: outstanding

Young people living in this home have complex physical and learning disabilities. This in no way prevents them from making excellent progress in many areas of their lives and enjoying a range of new and exciting experiences. This is because staff create a culture of inclusivity, and have high expectations for the young people in their care.

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Overall experiences and progress of children and young people: outstanding

Young people enjoy an extensive range of activities, including holidays to the seaside, visits to London, trips to the cinema, visits to safari parks and zoos, ice skating, and dancing. The organisation recently held a prom for all the young people, providing them with an opportunity to celebrate their educational progress. This is something they would not have had the opportunity to enjoy previously.

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Overall experiences and progress of children and young people: outstanding

Young people engage in community activities, attending local events and festivals. This Inspection report children’s home: SC406063 5 community involvement promotes confidence and self-esteem as they interact with others. Staff and young people have excellent relationships with their neighbours, and engage in the local online forum, sharing information about the locality. Young people also engage with other young people who are in care, with one young person being involved in forming the company’s website for young people. Staff facilitate contact with family and with previous carers. Staff provide a high degree of flexibility to meet the needs of families and young people.

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Overall experiences and progress of children and young people: outstanding

Excellent facilities within the home and in the garden provide stimulating and exciting activities for young people. A new sensory room has a large range of equipment, ensuring that every young person can enjoy a sensory experience. Sensory encounters continue in the newly refurbished garden with a range of equipment and planting, providing all young people with the opportunity to enjoy the outdoor space.

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Overall experiences and progress of children and young people: outstanding

The complex and, for some, total health and care needs of young people are exceptionally well managed. This improves their well-being, resulting in a significant reduction in hospital visits for some young people. Staff work in partnership with a range of health professionals effectively, including those with expertise in supporting young people who identify as transgender. Staff sensitively address this subject with the young person concerned, supported by the therapy team. This helps her to feel accepted and loved for who she is.

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Overall experiences and progress of children and young people: outstanding

While living at the home, young people experience improvements in their health, which enable them to access school on a more regular basis. This improves their academic achievement. Staff work closely with education providers and local authorities to ensure that moves to new schools are well planned. Where young people currently receive in- house tuition, the planned move to school will provide additional opportunities for social interaction. Education targets for each individual are clearly displayed in the home, enabling staff to complement their learning with activities.

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Overall experiences and progress of children and young people: outstanding

Young people receive excellent and individualised support in learning appropriate life skills. Work is set at the individual’s level of understanding. Young people continue to make excellent progress in this area. One young person is able to prepare simple meals; she also tidies her room and takes responsibility for her personal care needs, such as washing her hair. This improves her skills and builds her confidence and self-esteem.

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Overall experiences and progress of children and young people: outstanding

Excellent use of key-work sessions helps young people to explore topics such as health, relationships, autistic spectrum disorder and understanding gender. Discussions about dream jobs and aspirations for the future help young people to want to do well, and ensure that staff have high expectations.

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Overall experiences and progress of children and young people: outstanding

Staff create an environment that exudes warmth and nurture. Staff clearly understand the very complex needs of each individual. They are committed to providing the very best care and promoting outstanding outcomes. There is a real sense of fun and laughter in the home generated by the very good relationships between staff and young people. Inspection report children’s home: SC406063 6 Detailed planning for new placements ensures that young people settle swiftly. One recent transition has been exceptionally well managed. The young person, who has complex health needs, was in hospital during the transition period. Staff attended daily to observe and learn the care routines from medical staff, in order to complement the training they had already received. This enabled them to see at first hand the processes involved in meeting the young person’s medical needs. The social worker commented: ‘Although we had a robust transition, with staff being taught how to manage [name],

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Overall experiences and progress of children and young people: outstanding

they learnt while caring for him on the ward from nursing staff. The nursing staff on the ward commented on the staff regarding their commitment.’ Excellent work with medical professionals from across various counties, and with family and placing authorities has met his health needs. Together they have established a new diet to improve the young person’s health, and have provided additional therapeutic support. New medical protocols have also been established because of this working together; reducing the need for hospital admission when he has seizures by managing this in the home. This helps the young person to remain settled in the home without the constant need to be admitted to hospital. His social worker said: ‘He has been smiling, which has been good to see as this has not happened in a long time.’

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Overall experiences and progress of children and young people: outstanding

The home previously accommodated a short-break placement in addition to four permanent placements. Due to the level of expertise, skill set and facilities on offer, leaders took the decision to consolidate their service offer. They are now focusing more on caring for young people with complex and total care needs. This change has been managed very well, ensuring no young person is left without the appropriate support.

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Overall experiences and progress of children and young people: outstanding

Staff clearly understand the care plans for each young person, as well as their targets and how to help them achieve these. Staff regularly review and celebrate progress. They encourage young people to contribute to their plans and contribute to reviews of their progress. This helps them to recognise their achievements.

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Overall experiences and progress of children and young people: outstanding

Young people’s participation is exceptional. Regular house meetings are now fully inclusive, with staff utilising a range of sensory tools to ensure that each young person can contribute. This participation has already led to a number of improvements and changes. For example, new wheelchair-accessible garden furniture has been installed, and a sensory garden has been established. Young people have also been more able to choose activities because of the positive changes to the house meetings. Staff encourage young people to share their views and concerns. All young people have advocates if they feel they need to speak to someone outside of the home. One reviewing officer noted a huge improvement in a young person, and said that she was ‘finding her voice and being more vocal’.

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How well children and young people are helped and protected: good

Young people’s health conditions mean that they have very complex medication regimes. Despite this challenge, staff have a comprehensive understanding of when and how to administer each medication. The training staff receive in administering medication is exceptional. This includes the general principles of administration and recording and the Inspection report children’s home: SC406063 7 specific training required for meeting a range of complex health needs. Training is provided by a number of medical professionals. Staff have direct, face-to-face training, read theoretical texts and complete competency assessments, ensuring that they are fully competent and knowledgeable. Regular auditing and identified staff having specific responsibilities for medication for each shift reduce the risk of medication errors. Detailed health plans provide staff with comprehensive information about medical conditions, treatments, medications and dietary needs. These plans also provide

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How well children and young people are helped and protected: good

guidance on how to respond to emergency medical situations, such as seizures.

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How well children and young people are helped and protected: good

An extensive range of risk assessments details how to keep young people safe while they are enjoying activities and experiences. Assessment of the risk of bullying is very detailed, ensuring that young people continue to enjoy positive relationships.

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How well children and young people are helped and protected: good

Careful supervision eliminates the possibility of young people going missing. This does not mean that staff are oblivious to the risks; they understand what to do in the event of a young person going missing, and have clear protocols to follow.

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How well children and young people are helped and protected: good

Staff fully understand their safeguarding responsibilities. All are trained in safeguarding, including understanding the particular vulnerabilities of young people who have disabilities. Training on understanding topics such as sexual exploitation, female genital mutilation and radicalisation ensures that staff are aware of such issues. Staff also undertake training in health and safety, including fire safety. One young person has recently completed fire marshal training, and is now the young person’s fire safety representative.

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How well children and young people are helped and protected: good

A range of recruitment checks, including verification of references and enhanced criminal record checks, mean that new staff are carefully vetted, ensuring that they are unlikely to present a risk to young people.

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How well children and young people are helped and protected: good

Incidents of poor behaviour, including aggression and damage, have begun to decrease again following a recent peak. Inconsistencies in behaviour management plans have resulted in a lack of clarity regarding the best way to intervene and support young people during some incidents. Plans are also not explicit regarding why some strategies may be used as a last resort. The manager reviews incidents, but does not always record discussions with staff following her analysis. This means that some learning may be lost. Generally, the quality of recording is improving, though some poor use of language continues to be less than helpful when understanding the behaviour of young people.

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The effectiveness of leaders and managers: outstanding

The registered manager is qualified, very experienced and extremely passionate about the young people she and her team care for. The assistant manager and whole staff team replicate her passion for continued improvement.

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The effectiveness of leaders and managers: outstanding

The continuous improvement plan, or development plan, is excellent and is an effective tool for channelling this passion. Target-setting across three specified areas is constantly Inspection report children’s home: SC406063 8 evaluated and achievements are clearly and amply evidenced.

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The effectiveness of leaders and managers: outstanding

Recent recruitment, especially to senior posts, has brought a range of different skills and experiences to the team. High-quality inductions to the roles and continued training opportunities help to forge an exceptionally knowledgeable and skilled team. Staff are either qualified to the appropriate level, are on the relevant course or are currently in their probationary periods, ensuring that all staff are appropriately qualified within the required timescales.

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The effectiveness of leaders and managers: outstanding

Staff feel supported. Regular supervision and annual appraisals enable staff to reflect on their work and raise any concerns, as well as highlighting the progress they make as individuals. Team meetings provide a forum for open discussion and encourage group learning.

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The effectiveness of leaders and managers: outstanding

The statement of purpose provides an excellent overview of the service and its ethos and practice, all of which are fully understood and implemented by staff.

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The effectiveness of leaders and managers: outstanding

On a monthly basis, the independent visitor monitors the progress, care and safety of young people. The manager swiftly addresses any concerns, meeting the visitor’s recommendations for improvement. Monitoring carried out by the manager is excellent; she ensures that young people and staff contribute. She seeks and acts upon feedback from others, in order to continue improvements to the service.

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The effectiveness of leaders and managers: outstanding

Excellent partnership work provides holistic care, and helps young people to make progress. One organisation has been so impressed by the service that it has financially supported activities such as the prom. Other organisations and agencies speak very highly of staff and leaders. Comments from other professionals included: ‘This placement is marvellous, really marvellous I can’t say it enough. I can’t emphasise how positive the home is and how much [name] has improved.’

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the differences made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. Wherever possible, they talked to children and 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.

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Information about this inspection

Using the ‘Social care common inspection framework’, this inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, and to consider how well it complies with the Children’s Homes (England) Regulations 2015 and the ‘Guide to the Inspection report children’s home: SC406063 9 children’s homes regulations including the quality standards’. Inspection report children’s home: SC406063 10

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Children’s home details

Registered provider: Pathway Care Solutions II Ltd

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Children’s home details

Registered provider address: 1 Merchants Place, River Street, Bolton BL2 1BX

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Inspector

Judith Longden: social care inspector Inspection report children’s home: SC406063 11 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, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for children looked after, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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