Children's home run by Pathway Care Solutions Group Limited

Inspection report children’s home: SC482275 1 SC482275 Registered provider: Pathway Care Solutions Group Limited

p.1

Full inspection Inspected under the social care common inspection framework

p.1

Information about this children’s home

This children’s home is registered to care for up to four children who may have some emotional and/or behavioural issues.

p.1

Overall experiences and progress of

children and young people, taking into account

p.1

inadequate

How well children and young people are helped and protected inadequate

p.1

inadequate

The effectiveness of leaders and managers inadequate

p.1

inadequate

There are serious and widespread failures that mean children and young people are not protected or their welfare is not promoted or safeguarded and the care and experiences of children and young people are poor.

p.1

inadequate

Date of last inspection: 11 October 2017

p.1

inadequate

Overall judgement at last inspection: Not judged

p.1

Enforcement action since last inspection:

In May 2017, serious concerns were identified at this service. These concerns led to the home being suspended. As a result, there were no children living at this home from that date until October 2017. This is the first inspection, since the suspension, that has taken place when children have been living in this home. Inspection report children’s home: SC482275 2

p.1

Key findings from this inspection

This children’s home is inadequate because:

p.2

Key findings from this inspection

 Staff do not always identify when children need additional supervision to reduce the level of risks and to keep them safe. Care planning documentation does not provide enough detail for staff so that they fully understand what is expected of them. This leads to staff providing inconsistent care for the children and, at times, dangerous situations have occurred.  Children who live at this home are not consistently kept safe. Staff have not been provided with the training that they need to ensure that they have the skills and knowledge required to respond effectively to children’s presenting risks and behaviours.  The arrangements in place for the safe-keeping and the administration of medication are not effective or safe. These poor arrangements have impacted negatively on the health and well-being of children.

p.2

Key findings from this inspection

 The children are making good progress in some aspects of their lives, for example in education and with the positive aspirations they hold about their futures. These aspirations are supported and encouraged by the staff.

p.2

Inspection date Inspection type Inspection judgement

11/10/2017 Interim Not judged 22/03/2017 Interim Declined in effectiveness 15/11/2016 Full Good 08/02/2016 Interim Sustained effectiveness Inspection report children’s home: SC482275 3

p.2

Statutory requirements

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.

p.3

Requirement Due date

6: The quality and purpose of care standard

p.3

Requirement Due date

(1) The quality and purpose of care standard is that children receive care from staff who— (a) understand the children’s home’s overall aims and the outcomes it seeks to achieve for children; (b) use this understanding to deliver care that meets children’s needs and supports them to fulfil their potential. (2) In particular, the standard in paragraph (1) requires the registered person to— (a) understand and apply the home’s statement of purpose; (b) ensure that staff— (i) understand and apply the home’s statement of purpose; (ii) protect and promote each child’s welfare; (v) help each child to understand and manage the impact of any experience of abuse or neglect; (vi) help each child to develop resilience and skills that prepare the child to return home, to live in a new placement or to live independently as an adult; (ix) make decisions about the day-to-day arrangements for each child, in accordance with the child’s relevant plans, which give

p.3

Requirement Due date

the child an appropriate degree of freedom and choice; and (d) ensure that any care that is arranged or provided for a child that— (i) relates to the child’s development (within the meaning of section 17(11) of the Children Act 1989) or health; and (ii) is not arranged or provided as part of the health service continued under section 1(1) of the National Health Service Act 2006(a), satisfies the conditions in paragraph (3). (3) The conditions are— (a) that the care is approved, and kept under review throughout its duration, by the placing authority; (b) that the care meets the child’s needs; (c) that the care is delivered by a person who— 19/03/2018 Inspection report children’s home: SC482275 4 (i) has the experience, knowledge and skills to deliver that care; and (ii) is under the supervision of a person who is appropriately skilled and qualified to supervise that care; and (d) that the registered person keeps the child’s general medical

p.3

Requirement Due date

practitioner informed, as necessary, about the progress of the care throughout its duration. *12: The protection of children standard

p.4

Requirement Due date

1) The protection of children standard is that children are protected from harm and enabled to keep themselves safe. (2) In particular, the standard in paragraph (1) requires the registered person to ensure— (a) that staff— (i) assess whether each child is at risk of harm, taking into account information in the child’s relevant plans, and, if necessary, make arrangements to reduce the risk of any harm to the child; (ii) help each child to understand how to keep safe; (iii) have the skills to identify and act upon signs that a child is at risk of harm; (iv) manage relationships between children to prevent them from harming each other; (v) understand the roles and responsibilities in relation to protecting children that are assigned to them by the registered person; (vi) take effective action whenever there is a serious concern about a child’s welfare; and (vii) are familiar with, and act in accordance with, the home’s

p.4

Requirement Due date

child protection policies; (b) that the home’s day-to-day care is arranged and delivered so as to keep each child safe and to protect each child effectively from harm; (c) that the premises used for the purposes of the home are located so that children are effectively safeguarded; (d) that the premises used for the purposes of the home are designed, furnished and maintained so as to protect each child from avoidable hazards to the child’s health; and (e) that the effectiveness of the home’s child protection policies is monitored regularly. 19/03/2018

p.4

Requirement Due date

13: The leadership and management standard

p.4

Requirement Due date

(1) The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children’s home that— (a) helps children aspire to fulfil their potential; and (b) promotes their welfare. 19/03/2018 Inspection report children’s home: SC482275 5 (2) In particular, the standard in paragraph (1) requires the registered person to— (a) lead and manage the home in a way that is consistent with the approach and ethos, and delivers the outcomes, set out in the home’s statement of purpose; (b) ensure that staff work as a team where appropriate; (c) ensure that staff have the experience, qualifications and skills to meet the needs of each child; (e) ensure that the home’s workforce provides continuity of care to each child; (f) understand the impact that the quality of care provided in the home is having on the progress and experiences of each child and use this understanding to inform the development of

p.4

Requirement Due date

the quality of care provided in the home; (g) demonstrate that practice in the home is informed and improved by taking into account and acting on— (i) research and developments in relation to the ways in which the needs of children are best met; and (h) use monitoring and review systems to make continuous improvements in the quality of care provided in the home. 14: The care planning standard

p.5

Requirement Due date

1) The care planning standard is that children— (a) receive effectively planned care in or through the children’s home; and (b) have a positive experience of arriving at or moving on from the home. (2) In particular, the standard in paragraph (1) requires the registered person to ensure— (a) that children are admitted to the home only if their needs are within the range of needs of children for whom it is intended that the home is to provide care and accommodation, as set out in the home’s statement of purpose; (b) that arrangements are in place to— (ii) manage and review the placement of each child in the home; and (iii) plan for, and help, each child to prepare to leave the home or to move into adult care in a way that is consistent with arrangements agreed with the child’s placing authority; (c) that each child’s relevant plans are followed; (e) that the child’s placing authority is contacted, and a review

p.5

Requirement Due date

of that child’s relevant plans is requested, if— (i) the registered person considers that the child is at risk of harm or has concerns that the care provided for the child is inadequate to meet the child’s needs. 19/03/2018 Inspection report children’s home: SC482275 6 16: Statement of purpose

p.5

Requirement Due date

(1) The registered person must compile in relation to the children’s home a statement ("the statement of purpose") which covers the matters listed in Schedule 1. (a) Section 23 was amended by: paragraphs 103 and 110 of Schedule 3 to the ACA 2002; paragraphs 16 and 21 of Schedule 9 to the Health and Social Care (Community Health and Standards) Act 2003 (c.43); section 28 of the CYPA 2008 and section 104 of the C&FA 2014. (2) The registered person must provide a copy of the statement of purpose to HMCI and make a copy of it available upon request to— (a) a person who works at the home; (b) a child, or a child for whom accommodation in the home is being considered; (c) a parent of a child, or a parent of a child for whom accommodation in the home is being considered; (d) a child’s placing authority; and (e) in the case of a qualifying school, the Secretary of State. (3) The registered person must— (a) keep the statement of purpose under review and, where

p.6

Requirement Due date

appropriate, revise it; and (b) notify HMCI of any revisions and send HMCI a copy of the revised statement within 28 days of the revision. (4) If a home has a website, the registered person must ensure that a copy of the statement of purpose is published on that website unless the registered person considers that such publication would prejudice the welfare of children in the home. (5) Subject to paragraph (6), the registered person must ensure that the home is at all times conducted in a manner which is consistent with its statement of purpose. (6) Nothing in paragraph (5) or regulation 46 (review of premises) requires or authorises the registered person to contravene or not comply with— (a) any other provision of these Regulations; or (b) any conditions in relation to the registration of the registered person under Part 2 of the Care Standards Act 2000. 19/03/2018

p.6

Requirement Due date

(1) The registered person must make arrangements for the handling, recording, safekeeping, safe administration and disposal of medicines received into the children’s home. (2) In particular, the registered person must ensure that— (a) medicines kept in the home are stored in a secure place so as to prevent any child from having unsupervised access to them; 19/03/2018 Inspection report children’s home: SC482275 7 (b) medicine which is prescribed for a child is administered as prescribed to the child for whom it is prescribed and to no other child; and (c) a record is kept of the administration of medicine to each child. (3) Paragraph (2) does not apply to medicine which— (a) is stored by the child for whom it is provided in such a way that other persons are prevented from using it; and (b) may be safely self-administered by that child. (4) In this regulation, "prescribed" means— (a) ordered for a patient, for provision to the patient, under or

p.6

Requirement Due date

by virtue of the National Health Service Act 2006 or section 176(3) of the Health and Social Care (Community Health and Standards) Act 2003(b); or (b) in a case not falling within sub-paragraph (a), prescribed for a patient in accordance with regulation 217 of the Human Medicines Regulations 2012(c). 24: Monitoring and surveillance

p.7

Requirement Due date

(1) The registered person may only use devices for the monitoring or surveillance of children if— (a) the monitoring or surveillance is for the purpose of safeguarding and promoting the welfare of the child concerned, or other children; (b) the child’s placing authority consents in writing to the monitoring or surveillance; (c) so far as reasonably practicable in the light of the child’s age and understanding, the child is informed in advance of the intention to do the monitoring or surveillance; and (d) the monitoring or surveillance is no more intrusive than necessary, having regard to the child’s need for privacy. 19/03/2018

p.7

Requirement Due date

1) If a child dies, the registered person must without delay notify— (a) HMCI; (b) the placing authority; (c) the Secretary of State (if the Secretary of State is not the placing authority); (d) the local authority in whose area the children’s home is located (if that local authority is not the placing authority); (e) the clinical commissioning group (as defined in section 14D of the National Health Service Act 2006) for the area in which the home is located; (3) If there is a referral of a person working in the home pursuant to section 35 (Regulated activity providers: duty to refer) of the Safeguarding Vulnerable Groups Act 2006(a), the 19/03/2018 Inspection report children’s home: SC482275 8 registered person must without delay notify— (a) HMCI; (b) the placing authority; and (c) each other relevant person. (4) The registered person must notify HMCI and each other relevant person without delay if— (a) a child is involved in or subject to, or is suspected of being

p.7

Requirement Due date

involved in or subject to, sexual exploitation; (b) an incident requiring police involvement occurs in relation to a child which the registered person considers to be serious; (c) there is an allegation of abuse against the home or a person working there; (d) a child protection enquiry involving a child— (i) is instigated; or (ii) concludes (in which case, the notification must include the outcome of the child protection enquiry); or (e) there is any other incident relating to a child which the registered person considers to be serious. (5) A notification made under this regulation— (a) must include details of— (i) the matter; (ii) the other persons, bodies or organisations (if any) who or which have been notified; and (iii) any actions taken by the registered person as a result of the matter; (b) must be made or confirmed in writing. (6) In this regulation, references to the PPO include a person appointed by, or working on behalf of, the PPO for the purposes

p.8

Requirement Due date

of an investigation under paragraph (2).

p.8

Requirement Due date

* These requirements are subject to a compliance notice.

p.8

Overall experiences and progress of children and young people: inadequate

Leaders and managers fail to ensure that staff working at this home possess the skills, knowledge and experience that is required to care effectively for the children. The registered provider has invested heavily in training and support for staff, leaders and managers. However, there is a need for specialist training, clinical support and supervision so that staff are equipped with knowledge and the confidence to care for children and to identify when they might be vulnerable.

p.8

Overall experiences and progress of children and young people: inadequate

Children do not receive the care that will support their presenting needs and reduce risks for them. The care planning that is in place for children does not provide the staff with all of the details that they require to safely meet the children’s needs. This results in an inconsistent approach to the care that children receive. Inspection report children’s home: SC482275 9 Despite the complex needs of the children placed at this home, clinical input is not included in the care plans. Managers were unable to provide the inspector with information about the children’s specific diagnosed conditions. This means that the care provided does not take into account how staff should manage the significant emotional needs and high-risk behaviours that the children display.

p.8

Overall experiences and progress of children and young people: inadequate

Children who have moved to live at this home have been provided with good support to make moving in a positive experience. Children made visits to the home for dinner and other activities before the move. This has helped the children to feel more at ease and confident about their move.

p.9

Overall experiences and progress of children and young people: inadequate

Children are making progress at school. Appropriate plans are in place to ensure that the time children spend in education will increase. Good communication ensures that when children are struggling in education, action is taken to relieve some of the pressures. This supports the children to manage their emotional well-being.

p.9

Overall experiences and progress of children and young people: inadequate

Children hold positive and achievable aspirations about their futures. They know what they want to achieve and feel that the staff are supporting them to reach their goals. One example relates to a child who wants to be a firefighter. The child is supported by staff to attend a local gym regularly to help build up their fitness levels.

p.9

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

Since the previous inspection two significant incidents have occurred in the home, resulting in children being admitted to hospital. Staff missed key risk indicators that were being displayed and, as a result, they failed to keep the children safe. During one of these incidents, staff failed to call for urgent medical assistance and there was a delay in the emergency services being called. It is of concern that a similar incident led to this home being suspended from caring for children, less than a year ago.

p.9

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

Serious incidents are not managed well. Too often, staff have not identified concerning behaviours displayed by children or altered their approach to respond to these behaviours. Consequently, children have not been protected as well as they should be.

p.9

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

The arrangements in place for the safe-keeping of medication are not effective. For example, a child was able to gain entry to the office and medical cabinet, remove medication and take a significant overdose without staff being immediately aware. Likewise, the arrangements in place for the safe and effective administration of medication are inadequate. On one occasion, one child was given another child’s medication, and, in a separate incident, a child was not administered the correct prescribed dosage of their medication. These poor arrangements have impacted negatively on the health and well-being of the children.

p.9

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

On too many occasions, leaders and managers have failed to inform other agencies, including Ofsted and the designated officer, when significant incidents have occurred in Inspection report children’s home: SC482275 10 the home. This has prevented safeguarding processes from being considered and has obstructed external scrutiny and oversight from other agencies.

p.9

The effectiveness of leaders and managers: inadequate

Leaders and managers have failed to show that they have learned from previous inspections and rectified weaknesses in practice sufficiently. Serious shortfalls in practice have resulted in a failure to protect children. Leaders do not have a robust enough oversight of any incidents of concern involving the children. As a consequence, poor practice can sometimes go unnoticed and, therefore, any failings in care are left unaddressed for too long.

p.10

The effectiveness of leaders and managers: inadequate

Leaders and managers do not ensure that staff are provided with regular and meaningful supervision. There is a recognition that staff require additional specialist support, but this is not yet in place. Not all staff have been provided with an appraisal to identify their strengths and address weaknesses, despite acknowledging that they need additional specialist support. Overall, too many staff have not received the level of training required to ensure that they understand and can meet the children’s needs.

p.10

The effectiveness of leaders and managers: inadequate

Leaders and managers have not identified how the therapeutic and clinical needs of the children will be met. The current statement of purpose does not reflect the significant changes to the needs of the children who currently live here. The home is not operating in a manner that is consistent with the statement of purpose.

p.10

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.

p.10

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 children’s homes regulations including the quality standards’. Inspection report children’s home: SC482275 11

p.10

Children’s home details

Registered provider: Pathway Care Solutions Group Limited

p.11

Children’s home details

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

p.11

Inspector

Tracey Ledder, social care inspector Inspection report children’s home: SC482275 12 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 looked after children, safeguarding and child protection.

p.11

Inspector

If you would like a copy of this document in a different format, such as large print or Braille, please telephone 0300 123 1231, 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 http://www.nationalarchives.gov.uk/doc/open-government-licence , write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gsi.gov.uk .

p.12

Inspector

Interested in our work? You can subscribe to our monthly newsletter for more information and updates: http://eepurl.com/iTrDn .

p.12

Inspector

T: 0300 123 1231 Textphone: 0161 618 8524 E: enquiries@ofsted.gov.uk W: http://www.gov.uk/ofsted

p.12