Pathways

Updated 6 March 2021

The Inspection

This was a targeted inspection to check whether the provider had met the requirements of the specific concern we had about fire safety. As part of CQC’s response to the coronavirus pandemic we also looked at the preparedness of care homes in relation to infection prevention and control.

We will assess all of the key question at the next comprehensive inspection of the service.

Inspection team

This inspection was undertaken by one inspector

Service and service type

Pathways is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with the provider/registered manager, the deputy manager and senior carer. We reviewed a range of records relating to the management of the service.

Updated 6 March 2021

About the service

Pathways is a residential care home providing personal care to 10 people aged 65 and over at the time of the inspection. The service can support up to 12 people. It is a service for people who have a learning disability and/or autistic spectrum disorder, physical disabilities and sensory disabilities. Some people had complex needs.

The service is split into two bungalows. There were six people living in bungalow 56a and four people living in bungalow 56b.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

The service was not well led. The provider and management lacked oversight of the service.

Systems were in place to monitor the quality of the service; however, these were not effective and failed to highlight concerns raised during the inspection. Where issues had been raised, no action was taken to rectify this.

The service did not always manage and mitigate fire safety. We referred the service to the local fire authority.

Risks to people had no always been assessed according to need. Environmental checks were not completed in line with national guidelines. We found no evidence that people had been harmed however, systems were not robust enough to demonstrate safety was effectively managed. This placed people at risk of harm.

People received effective care from staff who understood how to recognise potential abuse. However not all concerns were appropriately raised through safeguarding procedures.

Staff and relatives told us there was not always enough staff in the service to support people.

Relatives told us the service did not provide meaningful activities for people. We recommend the service review their process for providing meaningful activities for people

End of life care plans were not always in place for people. We have recommended end of life care planning for people is developed.

The service did not always maintain and develop staff knowledge and skills, however knew people and their needs well.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, capacity assessments had not always been completed in line with guidance.

Relatives told us the environment was dated and required improvement. We have made a recommendation about the environment of the service.

Information was not always available in other formats to aid people’s understanding where required.

Staff respected people's privacy and dignity and interacted with people in a caring and compassionate way.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 21 December 2016).

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.