Children's home run by Pathway Care Solutions Group Limited

Inspection report for children’s home - monitoring visit: SC482275 1 SC482275

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Pathway Care Solutions Group Limited

Inspected under the social care common inspection framework

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Information about this children’s home

This home was judged to be inadequate at the last full inspection in February 2018. This monitoring visit was undertaken to review progress made in respect of two compliance notices served following that inspection. The compliance notices were in respect of the protection of children and the safe keeping and administration of medication.

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This monitoring visit

There have been no safeguarding concerns raised or identified since the last inspection. This means that the inspector was only able to review systems and processes during this visit. Changes made to areas of child protection have not been tested in practice.

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This monitoring visit

Relationships between the placing authority, specialist health teams and this service have improved since the last inspection. This has resulted in a more collaborative approach to ensuring that the children who live in this home have safer and better care that is tailored to their individual needs. While there are still some gaps within the children’s documents in respect of expectations on staff and accountability; enough progress has been made to reassure the inspector that safer and more consistent and appropriate care is being provided to children.

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This monitoring visit

Leaders and managers have taken steps to ensure that staff are provided with the training they require to ensure that children are cared for safely. Training already undertaken has supported staff in improving their confidence and skills. More training has been arranged and the impact of this will be reviewed at the next full inspection. Arrangements are under way for staff to be provided with clinical supervision and for this to be embedded into their practice. This is not yet in place. Managers anticipate that this will have a positive impact on staff and the care that they provide for children. Inspection report for children’s home - monitoring visit: SC482275 2 Leaders and managers have arranged for a number of partner agencies to attend team meetings. For example, child and adolescent mental health workers have attended one meeting. This supported staff to consider the current and emerging needs for children and consider how best to manage these issues. In addition, the

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This monitoring visit

designated officer is due to attend a team meeting. The purpose of this is to ensure that there is clarity about their role and greater confidence about making contact with them. These arrangements are deemed positive by the managers at the home.

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This monitoring visit

The arrangements in place for the safe keeping and administration of medication have had a complete and positive overhaul since the last inspection. The systems in place are much easier for staff to understand and are now fit for purpose. In addition, staff have been provided with medication training and have discussed previous mistakes and errors in team meetings. As a result there have been no medication errors or recording mistakes since the last inspection.

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This monitoring visit

Leaders and managers have put systems in place to ensure that they have greater and a more effective overview of incidents and concerns. The arrangements in place for staff supervision have also been reviewed. These changes have allowed managers to provide additional support to staff and address any areas of concern in a formal and transparent way. These systems are new and are only just being tested in practice. This will be reviewed further at the next full inspection.

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Recent inspection history

Inspection date Inspection type Inspection judgement 07/02/2018 Full Inadequate 11/10/2017 Interim Not judged 22/03/2017 Interim Declined in effectiveness 15/11/2016 Full Good Inspection report for children’s home - monitoring visit: SC482275 3

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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.

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Requirement Due date

6: The quality and purpose of care standard

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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,

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Requirement Due date

which give 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— (i) has the experience, knowledge and skills to deliver that 19/03/2018 Inspection report for children’s home - monitoring visit: SC482275 4 care; and (ii) is under the supervision of a person who is appropriately skilled and qualified to supervise that care; and

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Requirement Due date

(d) that the registered person keeps the child’s general medical practitioner informed, as necessary, about the progress of the care throughout its duration. 12: The protection of children standard

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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

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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

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Requirement Due date

13: The leadership and management standard

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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. (2) In particular, the standard in paragraph (1) requires the 19/03/2018 Inspection report for children’s home - monitoring visit: SC482275 5 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

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Requirement Due date

of 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

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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 of that child’s relevant plans is requested, if—

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Requirement Due date

(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

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Requirement Due date

16: Statement of purpose 19/03/2018 Inspection report for children’s home - monitoring visit: SC482275 6 (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.

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Requirement Due date

(3) The registered person must— (a) keep the statement of purpose under review and, where 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

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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 for children’s home - monitoring visit: 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

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Requirement Due date

or 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

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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

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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; (f) if the child was accommodated in a secure children’s home, the Prisons and Probation Ombudsman for England and Wales (‘the PPO’); and 19/03/2018 Inspection report for children’s home - monitoring visit: SC482275 8 (g) each other relevant person. (2) If a child accommodated in a secure children’s home dies, the registered person must allow the PPO to investigate the death by— (a) granting the PPO access to— (i) the premises of the home; and (ii) the home’s documents and records;

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Requirement Due date

(b) allowing the PPO to take away from the premises, securely, copies of any documents or records provided under sub-paragraph (a)(ii); and (c) if they consent, allowing the PPO to interview in private any children, parents or relatives, or persons working at the home. (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 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 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

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Requirement Due date

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 of an investigation under paragraph (2). Inspection report for children’s home - monitoring visit: SC482275 9

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Information about this inspection

The purpose of this visit was to monitor the action taken and the progress made by the children’s home since its last Ofsted inspection.

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Information about this inspection

This inspection was carried out under the Care Standards Act 2000. Inspection report for children’s home - monitoring visit: SC482275 10

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Children’s home details

Registered provider: Pathway Care Solutions Group Limited

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Children’s home details

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

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Inspector

Tracey Ledder, social care inspector Inspection report for children’s home - monitoring visit: SC482275 11 to 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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