Pathfinders Neurological Care Centre

Pathfinders is a care home providing personal and nursing care. The service specialises in supporting people with complex health and social care needs. The service can support up to 78 people. At the time of the inspection, 64 people were using the service and living across six different units.

We found the following examples of good practice.

¿Regular newsletter bulletins were sent to relatives and family members to keep them up to date and informed about any changes to the service.

¿ At the time of the inspection the home was following the current government guidance in relation to infection prevention and control. There were no relatives visiting people at the home. The provider ensured that people using the service could maintain links with family members and friends. They were able to communicate with their relatives using video calls and telephone calls. People who were at the end of their lives could still have relatives visit them

¿ The service had reviewed their Personal Protective Equipment (PPE) policy and implemented enhanced PPE measures to reduce the risk of infection spread. Staff had received appropriate training and updates about COIVD-19. Staff were trained on to safely put on and take off their PPE and were observed wearing appropriate PPE.

¿ The service used a range of observation tools to ensure people’s health was maintained. Where concerns were noticed, the provider liaised with GP to ensure appropriate treatment and medicines were prescribed.

¿ Systems for cleaning communal areas and people’s bedrooms were effective. The service looked clean throughout. The provider introduced enhanced cleaning and decontaminations methods. The service was using outside company to professionally launder linen and towels.

Further information is in the detailed findings below.

Pathfinders is a care home providing personal and nursing care. The service specialises in supporting people with complex health and social care needs. The service can support up to 78 people. At the time of the inspection, 67 people were using the service and living across six different units.

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

Some risks were not always managed safely at the service. Bed rails were not managed safely, which put people at risk of injury. Some medicine was required to be given at a certain time, but the time it was given was not always recorded by staff. Care files had photos of people on the front, so staff could identify who they were supporting. However, we found some photographs of people were out of date and no longer accurately represented people. This put people at risk of not receiving appropriate support.

People and staff told us that at times staffing levels were not sufficient to meet people’s routine needs in a timely way (urgent needs were met quickly). We advised the provider of this and they advised they would consider the deployment of staff around the building.

People told us they felt safe at the service. Records showed us that incidents were reviewed, and action was taken to prevent reoccurrence. The service was clean and followed good infection control processes.

People at the service had complex health and social care needs. These needs were supported in line with current standards and legal regulations. Staff received a variety of training and worked with both internal and external professionals to ensure that people received effective care.

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.

People received compassionate support from the staff. People were able to make choices about their daily routines and activities that they wished to engage with. Staff supported people to have privacy and dignity. An on-site therapy team supported people to have rehabilitation goals and aim for greater independence. This had positive outcomes for people.

People were consulted at the service, and able to make complaints if they wished. Those people who had made complaints, had received a full investigation and formal response.

Other than the issues identified in the report, the governance process at the service was effective and ensured that good quality care was provided and maintained.

Staff teams worked hard to ensure that people’s diverse needs were recognised and met at the service. People were involved with feeding back about the care they received, we viewed people’s feedback and it was positive about the quality of care they received. This was supported by feedback at the inspection visit, where people reported receiving a good quality service.

Rating at last inspection

The last rating for this service was Good (published 7 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

People continued to feel safe and staff ensured that risks to their health and safety were reduced. There were sufficient staff to meet people’s needs in a timely manner and systems were in place to support people to take their medicines.

Staff received relevant training and felt well supported. People were asked for their consent and appropriate steps were taken to support people who lacked capacity to make particular decisions. People were supported to eat and drink enough to maintain good health.

There were positive and caring relationships between people and the staff who cared for them. Staff promoted people’s right to make their own decisions and respected the choices they made. People were treated with dignity and respect by staff who understood the importance of this.

People received person-centred and responsive care from staff who had a clear understanding of their current support needs. Care plans were in place which provided information about the care people required, although some sections required updating. People knew how to make a complaint and there was a clear complaints procedure in place.

There was an open and transparent culture which enabled people and staff to speak up if they wished to. The management team provided strong leadership and a clear direction to staff. There were robust quality monitoring procedures in place.

Further information is in the detailed findings below.

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

Medicines were not always handled appropriately. We observed the nursing staff with nursing staff assistants during the morning and afternoon medicines round. Medicine administration record (MAR) charts were also signed before medicines had been administered to people. This demonstrated that the procedures they used were not always safe and did not follow best practice.

We found people were supported to make decisions about their care. People's individual characteristics were respected and their privacy and dignity were promoted. A person who used the service told us, 'I feel I am given choices, asked for my views and listened to.' Another person told us, 'I think I am treated with respect, on the whole I would say they are very respectful.'

We found people received care and support that met their needs and suitable arrangements were in place to manage any medication. A person who used the service told us, 'This is the best place I have ever been in. In two weeks they have got me walking again.' Another person told us, 'I don't worry about my medication, they look after that well.'

We found the staff team were supported through training and the provider assessed and monitored the quality of the service. A person described the staff as, 'Well trained and effective.' Another person said they thought the home was well led.

People's individual needs were respected. A person who used the service told us, 'I know I am a difficult case and all my needs are met. They identified my differences when I came here.'

Staff ensured people feel safe and secure. A person told us, 'If I have not buzzed them (staff) for a while they pop in and check on me. If I am having a wobble they sit down and talk to me.' They also said, 'They don't let just anyone walk into the building.'

People who used the service said most of the time they got a good service but were able to give us some examples where they had to wait to receive the support they needed.

People were encouraged to express their views about the services they received. One person told us, 'You feel they want to know if there is a problem, they ask you all the time.'