Pathways to Independance

Updated 4 June 2019

The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

Inspection team: One inspector completed this inspection.

Service and service type: This service is a domiciliary care agency. It provides personal care to people who are living with disabilities and are living in their own houses and flats.

Not everyone using Pathways to Independance receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’, such as help with tasks related to personal hygiene and assistance to eat. For people the provider helps with these tasks, we also consider any wider social care provided for them.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection: We gave the service 48 hours’ notice of the inspection visit because we needed to be sure that the registered manager would be in.

Inspection site visit activity started on 17 April 2019 and ended on 26 April 2019. We visited the office location twice to see the registered manager and office staff; and to review care records and policies and procedures.

What we did: We assessed information we had received about the service, which included details about incidents the provider must notify us about, such as abuse, feedback from the local authority and professionals who work with the service.

Providers are required to send key information about their service, what they do well and improvements they plan to make. This information helps support our inspections. We took this into account when we inspected the service and made the judgements in this report.

During the inspection, we spoke with three of the seven people who needed support with their personal care and four relatives. We received written feedback from another three people who used the service. We spoke with the registered manager, the senior team leader, an administrator and 14 support workers. We reviewed a range of records. This included four people's care records, medication records and various records related to recruitment, staff training and supervision, and the management of the service.

Updated 4 June 2019

About the service: Pathways to Independance provides care at home services for 107 adults and children living with disabilities. The children and young people who used the service did not need support with their personal care. Seven adults needed assistance with their personal care and staff supported the remaining people to engage in a range of activities within the community or with domestic tasks.

Pathway to Independance provides a concierge service for a block of six self-contained flats. They run a drop-in facility in the adjacent building to their office for people to come and meet up with friends, take part in activities and relax. They, also, provide a play area for children which has sensory lights, equipment, games, toys and a range of activities. To use any of these facilities people must be referred to them by social workers and healthcare professionals.

People’s experience of using this service: People and relatives stated that overall, they were very happy with the support they received. One person commented, "They are brilliant. Other companies have been atrocious but we can’t fault this one, as the staff are great and very good at their job." Staff worked very closely and sensitively with people and supported them to experience a wider range of activities as well as improve their daily living skills. People said all the staff were friendly and made them feel at ease.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The provider had recently reviewed the documents they kept in relation to working with people who lacked capacity to make decisions and found these needed to be improved. New templates had been introduced, which met the requirements of the Mental Capacity Act 2005 (MCA).

Staffing levels met people’s needs. Staff were well trained and knowledgeable about their roles and the care people needed. Staff received a wide range of training including how to work with children and young people and people living with a learning disability.

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/or 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.

Systems and processes were in place to closely monitor the service to make sure it was safe and run well. The service was well run. Staff and people's views were gathered and used to inform developments at the service. The registered manager made sure that the staff were delivering a good service. The registered manager and staff had robust risk assessments and acted appropriately to mitigate any identified risks. Medicines were managed in an appropriate manner.

Staff effectively reported any safeguarding matters. The registered manager thoroughly investigated any concerns and resolved these matters. All incidents were critically analysed, lessons were learnt and embedded into practice.

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

Rating at last inspection: Good (report published 21 October 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection.

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