Pathways Health Care Limited

Updated 30 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We inspected the service on 23 November 2017. The inspection was unannounced. The inspection team consisted of two inspectors.

Prior to our inspection we reviewed information we held about the service. This included previous inspection reports, information received and statutory notifications. A notification is information about important events which the provider is required to send us by law. We sought feedback from health and social care professionals who have been involved in the service and commissioners who fund the care for some people who use the service. Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

During the visit we spoke with one person who used the service. Some people who used the service had limited verbal communication and so we also relied on observations and spoke with the relatives of three people who used the service.

We spoke with three members of support staff, a nurse, a housekeeper and the registered manager. We looked at the care records of five people who used the service, medicines records, staff recruitment and training records, as well as a range of records relating to the running of the service including audits carried out by the registered manager and registered provider.

Updated 30 December 2017

We inspected the service on 23 November 2017. The inspection was unannounced. Pathways Health Care Limited is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service is a care home service with nursing. Pathways Health Care Limited is registered to accommodate ten people in one adapted building. On the day of our inspection eight people were using the service and the registered manager told us that two of the bedrooms were no longer in use and would not be in the future.

At the last inspection, in October 2015, the service was rated Good. At this inspection we found that the service remained Good. However, the rating for the Responsive domain has changed from Good to Requires Improvement.

The service had a registered manager in place at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Risks in relation to people's daily life were assessed and planned for to protect them from harm and they lived in a clean, hygienic service. People were supported by staff who knew how to recognise abuse and how to respond to concerns. We have recommended the provider considers improving the system for analysing incident records to ensure this does not occur again.

Medicines were managed safely and people received their medicines as prescribed. People were supported by staff who sought to understand, prevent and manage behaviour that the service found challenging and supported by enough staff to ensure their personal care needs were responded to in a timely way.

People were supported by staff who had the knowledge and skills to provide safe and appropriate care and support. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People were supported to maintain their nutrition and staff were monitoring and responding to people’s health conditions.

People lived in a service where staff listened to them and got to know them. People's support needs were recognised and responded to by a staff team who recognised the importance of respecting people’s privacy and dignity. Information about people's needs was shared between services to ensure people would be supported in other settings when needed.

People were supported to participate in activities and to socialise, however this was sometimes restricted due to the availability of staff. We have recommend the provider considers assessing staffing levels to ensure there are enough staff on duty to enable people to access the community when they wish to.

People lived in a service which met their needs in relation to the premises and adaptions were made where needed. People had access to information in a format which met their needs and were able to raise concerns if they needed to.

People were involved in giving their views on how the service was run and there were systems in place to monitor and improve the quality of the service provided.