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

Inspection report for children's home: 1277045 1 Registered provider: Pathway Care Solutions 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

The home provides care for up to four children who may experience learning difficulties and/or social or emotional difficulties. It is part of a large organisation. At the time of the inspection, three children were living in the home.

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Information about this children's home

The manager has been in post since August 2023. She has applied to register with Ofsted.

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Overall experiences and progress of

children and young people, taking into account

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requires improvement to be good

How well children and young people are helped and protected requires improvement to be good

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requires improvement to be good

The effectiveness of leaders and managers requires improvement to be good

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requires improvement to be good

The children's home is not yet delivering good help and care for children and young people. However, there are no serious or widespread failures that result in their welfare not being safeguarded or promoted.

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requires improvement to be good

Overall judgement at last inspection: good

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requires improvement to be good

Enforcement action since last inspection: none Inspection report for children's home: 1277045 2

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Inspection date Inspection type Inspection judgement

21/08/2023 Full Good 21/09/2022 Full Good 12/10/2021 Full Good 07/11/2019 Interim Improved effectiveness Inspection report for children's home: 1277045 3

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improvement to be good

Since the last inspection there has been a period of significant change in the home. Many staff have left and new, less experienced staff have joined. As a result of staffing challenges, managers have been increasingly required to provide support and guidance. Children have had to get used to new faces, and cope with the loss of known staff from their lives. The focus has been on supporting staff to get to know children and to understand their needs. As such, support for children to develop and make progress has been limited.

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improvement to be good

Staff provide children with fun filled evenings and weekends. Children visit the beach and the woods, soft play and theme parks. Staff understand what children enjoy, and also push them to try new experiences. In the home children have toys for creative and imaginative play, and a garden with space for play.

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improvement to be good

Children have good school attendance. Staff work closely with the school to share strategies and to provide consistency and stability. A clinical team of therapists work across both settings to further support this.

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improvement to be good

The manager has introduced new newsletters to the children to celebrate their achievements and enjoyment over the month. Staff have created memory books for children, however these are not kept up to date. Due to the level of staff turnover, there is a risk that the detail of memories will become lost.

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improvement to be good

The physical environment is not consistently homely or welcoming. There are two TVs in unsightly boxes, and decoration is sparse. Walls are scuffed and in places the floor is stained. Both the bathroom and kitchen are in need of refurbishment. The organisation recognise the need for these improvements and have plans to address this. Staff carry large bunches of keys with them which creates an institutional feeling. The manager has plans to implement a new single key system.

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improvement to be good

Children physically and verbally harm each other. Staff are also harmed by children. Staff intervention does not always keep children safe and stop these incidents. Leaders and managers have recognised that they cannot meet the combined needs of all children. There are plans for one child to move on from the home. As an interim measure staff carefully plan children’s time to better manage interactions and minimise risk.

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improvement to be good

Since the previous inspection there have been 27 incidents of restraint. All three children have been physically restrained by staff. Poor management oversight means that there is not enough scrutiny of incidents to fully understand whether these interventions have Inspection report for children's home: 1277045 4 been necessary and proportionate. The manager does not identify gaps in recording which could indicate that untrained techniques are used. There is a lack of scrutiny about staff action in relation to the wider incident, such as whether staff responding differently at an earlier stage could have resulted in a different outcome. Debriefs with staff after incidents do not always fully explore these issues. Conversations with children about the incidents often lack detail. Learning from both the incidents and conversations is not identified or shared with the wider staff team.

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improvement to be good

Concerns raised about staff practice have been investigated and shared with safeguarding authorities. While these investigations identify learning, this is not always disseminated wider. In one instance, there has been a significant delay in the recommended training taking place. This reduces the impact and relevance, and means that staff practice is continuing unchecked.

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improvement to be good

Staff use social stories creatively to help children understand their world and to give information to them. This helps to reassure them and provides an ongoing visual reference. Staff speak with children and support them with conversations about safety and wellbeing. Staff understand that children have complex communication needs. However, children’s plans lack clarity about how to support children’s communication. Staff work well to ensure children understand them. There is less clarity about how children express their views outside of specific time for two-way discussion.

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improvement to be good

Medication processes are thorough. Where safe and possible children are encouraged to administer their own medication. One child has specific health needs around eating and drinking. While staff have a basic understanding of their needs, the plans to support this in a safe and well managed way lack clarity. Information from professionals is not fully reflected in plans. It is therefore not clear that the child receives consistent and safe support.

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improvement to be good

Recruitment of permanent staff follows safer recruitment guidance. For temporary staff, leaders confirm there are suitable disclosure and barring checks in place. However they do not clarify other information such as employment history.

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improvement to be good

The location risk assessment does not contain information from consultation with others about the suitability of the location. The manager took action during the inspection to rectify this.

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The effectiveness of leaders and managers: requires improvement to be good

Due to significant staffing challenges, both the manager and deputy manager have had to undertake more practical support in the home. This has significantly impacted on the time they have to undertake management tasks, including monitoring and oversight. There have been a significant number of incidents in the home. While the manager ensures oversight is on all of the records, the quality and helpfulness of this is limited. Patterns and trends are not tracked or identified and so there is a lack of learning. Senior leaders have identified some of the shortfalls and have a plan in place to provide the support and mentoring needed to re-establish effective monitoring. Inspection report for children's home: 1277045 5 Staff enjoy working in the home and say they are supported by their managers. They recognise the practical support given, including working long days, or directly during incidents. Staff supervision and team meetings take place, however these do not provide

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The effectiveness of leaders and managers: requires improvement to be good

spaces for constructive learning or reflection. This is due to the wider challenges with management oversight to identify this in the first instance.

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The effectiveness of leaders and managers: requires improvement to be good

Managers track and understand staff training needs. The centralised system supports tracking for most courses. However, there is a gap where specific and bespoke training is delivered to the team, such as that from the therapy team. The system as it stands does not capture this individualised learning that takes place. This means it does not reflect the support and training staff have had, or allow managers to know when this needs to be repeated.

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The effectiveness of leaders and managers: requires improvement to be good

Staff review and update children’s plans and other relevant documents. Care plans contain good information about children’s history and experiences. However, some plans lack clarity about approaches and support for children who do have complex needs. This again links to the lack of management oversight and learning to inform staff support to children.

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The effectiveness of leaders and managers: requires improvement to be good

Social workers are positive about care children receive and progress children make. They say staff keep them informed about incidents that occur, but sometimes day to day information can be slower to be shared.

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The effectiveness of leaders and managers: requires improvement to be good

An updated statement of purpose was not shared with Ofsted, and the document did not contain the necessary information. This was reviewed, updated and submitted during the inspection. Inspection report for children's home: 1277045 6

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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

The leadership and management standard is that the registered person enables, inspires and leads a culture in relation to the children's home that—

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Requirement Due date

helps children aspire to fulfil their potential; and

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to—

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Requirement Due date

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;

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Requirement Due date

ensure that staff have the experience, qualifications and skills to meet the needs of each child;

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Requirement Due date

ensure that the home's workforce provides continuity of care to each child;

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Requirement Due date

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 the quality of care provided in the home;

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Requirement Due date

use monitoring and review systems to make continuous improvements in the quality of care provided in the home. (Regulation 13 (1)(a)(b) (2)(a)(c)(e)(f)(h))

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Requirement Due date

In particular, the registered person should ensure there are suitable systems in place to monitor and review care in the home, particularly incidents of restraint. The registered person should ensure any learning identified is shared with the staff team and changes made in response are done in a timely way. In addition, they should ensure that a stable and skilled staff 2 August 2024 Inspection report for children's home: 1277045 7 team provide consistent support to children to enable them to make progress in line with the homes statement of purpose.

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Requirement Due date

The positive relationships standard is that children are helped to develop, and to benefit from, relationships based on—

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Requirement Due date

an understanding about acceptable behaviour; and

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Requirement Due date

positive responses to other children and adults.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure—

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Requirement Due date

help each child to develop socially aware behaviour;

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Requirement Due date

encourage each child to take responsibility for the child's behaviour, in accordance with the child's age and understanding;

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Requirement Due date

help each child to develop and practise skills to resolve conflicts positively and without harm to anyone;

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Requirement Due date

communicate to each child expectations about the child's behaviour and ensure that the child understands those expectations in accordance with the child's age and understanding;

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Requirement Due date

de-escalate confrontations with or between children, or potentially violent behaviour by children (Regulation 11 (1)(a)(b) (2)(a)(ii)(iii)(iv)(v)(xi))

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Requirement Due date

In particular, ensure staff have the skill and support to help children manage their relationships with each other positively, and that where necessary they can intervene to stop others being harmed. 21 June 2024

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Requirement Due date

The health and well-being standard is that—

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Requirement Due date

the health and well-being needs of children are met;

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Requirement Due date

children receive advice, services and support in relation to their health and well-being; and 17 May 2024 Inspection report for children's home: 1277045 8 children are helped to lead healthy lifestyles.

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Requirement Due date

In particular, the standard in paragraph (1) requires the registered person to ensure—

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Requirement Due date

achieve the health and well-being outcomes that are recorded in the child's relevant plans. (Regulation 10 (1)(a)(b)(c) (2)(a)(i))

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Requirement Due date

In particular, ensure there are clear plans for one child's support needs with eating and drinking, and that these are well understood by staff.

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Requirement Due date

The registered person must recruit staff using recruitment procedures that are designed to ensure children's safety.

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Requirement Due date

employ an individual to work at the children's home; or

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Requirement Due date

if an individual is employed by a person other than the registered person to work at the home in a position in which the individual may have regular contact with children, allow that individual to work at the home,

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Requirement Due date

if the individual satisfies the requirements in paragraph (3).

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Requirement Due date

full and satisfactory information is available in relation to the individual in respect of each of the matters in Schedule 2. (Regulation 32 (1) (2)(a)(b) (3)(d))

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Requirement Due date

In particular, ensure the necessary information required under schedule 2 is obtained for all staff who work in the home. 6 June 2024

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Recommendations

 The registered person should ensure the environment is homely and in a good state of repair. Where adaptations are required as a result of individual children's needs this should be clearly detailed in their plans and reviewed regularly and alternative strategies considered. ('Guide to the Children's Homes Regulations, including the quality standards', page 15, paragraph 3.9) Inspection report for children's home: 1277045 9  The registered person should ensure that children's plans clearly outline how to promote and support their communication, including and tools or resources that are required. Those tools should be available around the home to support children to express themselves. ('Guide to the Children's Homes Regulations, including the quality standards', page 22, paragraph 4.6)

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Recommendations

 The registered person should ensure that conversations with children after incidents reflect on what has happened and are considered by the manager for the learning identified. ('Guide to the Children's Homes Regulations, including the quality standards', page 50, paragraph 9.6)

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Recommendations

 The registered person should ensure that they speak with staff after incidents of restraint in the home to reflect on practice and identify any training needs. ('Guide to the Children's Homes Regulations, including the quality standards', page 49, paragraph 9.56)

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Recommendations

 The registered person should ensure children's memory books are kept up to date to ensure the detail of events and outings is not lost. ('Guide to the Children's Homes Regulations, including the quality standards', page 62, paragraph 14.5)

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people, 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 for children's home: 1277045 10

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Children's home details

Registered provider: Pathway Care Solutions Ltd

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Children's home details

Registered provider address: Atria, Spa Road, Bolton BL1 4AG

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Children's home details

Responsible individual: Alison Blyth-Bishop

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Inspectors

Clare Nixson, Social Care Inspector Nickie Doney, Social Care Inspector Inspection report for children's home: 1277045 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 looked after children, safeguarding and child protection.

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Inspectors

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Inspectors

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Inspectors

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