Pathways Health Care Limited

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care and wellbeing, however staff and relatives felt they were not always included in this process. Relatives raised concerns that agency staff could not provide them with updates about people’s ongoing care which led to them experiencing delays in receiving information which at times caused undue stress. One relative said, “[Name] recently had a hospital appointment, and I was awaiting an update but there was only an agency staff member available who didn’t know anything about the appointment, so I didn’t know what was happening or if [name’s] care had changed.”

The provider was open and honest about current staffing challenges and the impact this was having within the service; however, they had a clear action plan for improvement. The registered manager said, “We are recruiting and while this happens all staff are working to keep care as consistent as possible, but we want to make sure people we employ are the right fit for the service and can meet people’s needs otherwise this situation will happen again.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. A range of national risk assessments were in use to ensure any risks were identified using best practice guidance. For example, a nationally recognised wound assessment tool was used to identify people at risk of pressure damage, a nutritional risk assessment tool was used to highlight people at risk of malnutrition. The use of tools identifies areas of risk and provides guidance to staff to provide effective care. The provider had sought external professionals to support people where appropriate. For example, we saw referrals to mental health services and physiotherapists.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. External professionals we spoke with told us the provider and staff were responsive to their recommendations and worked well with them when changes to people’s care were needed. One professional said, “The management team are very good and always respond quickly with information when needed, they follow my advice and care plans seem detailed from what I have observed.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. During the assessment we saw people supported in person centred ways to achieve their goals including supporting living healthier lives. For example, people were encouraged and supported to improve mobility and exercise levels with walks in the local community. Other people were supported to access swimming facilities.

The provider routinely monitored people’s care and treatment to continuously improve it. The provider, registered manager and staff were all passionate about ensuring people received positive outcomes. However, care plans did not always detail people’s long-term goals or how they progressed in achieving those aims. Staff and relatives could describe people meeting goals such as days out and holidays, but care plans did not contain this information or what support staff had provided to ensure people were prepared, motivated and supported to achieve positive outcomes.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff completed training regarding the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to make decisions, any made on their behalf must be in their best interests and as least restrictive as possible. Where people lacked capacity, mental capacity assessments had been completed in line with the legal framework. Where people did not have a relative or loved one to advocate for them, the service supported people to access independent advocate services to ensure their needs, wishes and views were represented and recorded. Some people at the service were subject to a Deprivation of Liberty Safeguard (DoLS), this is where the person cannot make decisions about their care and treatment, so restrictive care arrangements are legally authorised in the person’s best interest. Staff had knowledge of DoLS and how this impacted people. We found conditions attached to authorisations were complied with and detailed in people’s care records. We observed staff ask consent before providing care, people’s right to say ‘No’ was respected and we observed staff reattempt using a different approach. This meant people’s human rights were respected.