Pathways Health Care Limited

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Lesson learned were discussed daily at meetings between the management team and staff. Where incidents had happened and staff had completed incident forms, the management team had consistently reviewed these to identify and mitigate any potential ongoing risk to people and shared the learning quickly with all staff to improve their knowledge and to ensure people’s ongoing safety.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. People had documents in place such as hospital passports to enable external professionals to support them in their chosen way without the need of people having to communicate their wishes repeatedly. Additionally, people had communication passports in place, which described their preferred communication method. Where people were unable to communicate verbally these documents contained guidance on what was important to people and how they communicated and expressed themselves through body language, sounds and gestures. This meant external professionals could learn the persons preferred communication method and support them safely.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. People had a staff member who was assigned as their key worker. This meant staff were able to build trusting relationships with people. Staff we spoke with were extremely knowledgeable about safeguarding risks and what this meant individually to people living at the home. For example, staff were aware of people who were at a potentially higher risk of safeguarding concerns such as self-neglect or emotional abuse. Where concerns had been raised the management team had shared and reported concerns quickly and appropriately to the relevant agencies such as CQC and the local authority.

The provider did not always work well with people to understand and manage risks. Relatives and staff told us they were not always included in care plan reviews. One staff member said, “Care plans are detailed but not always up to date, I work with people every day and know their changing needs so I feel it would help if I was included.” A relative said, “I have never seen the care plan, even though we discuss the care I don’t know if what is recorded is accurate.”

Care plans reviewed on the assessment had been regularly updated however at time there was conflicting information recorded in care plans. For example, one person’s care plan showed their mobility needs had changed, and they now needed equipment when mobilising. However other areas of the care plan and risk assessment planning had not been updated with this information. We fed this back to the management team who took immediate action.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The registered manager told us that the home was allocated an annual budget for improvements and people were involved in making decisions as to what the budget was spent on. The provider was currently recruiting for an ongoing maintenance role for the home, however the registered manager had access to help and support from the maintenance team at another home run by provider which was located opposite Pathways Health Care Limited. This ensured the environment remained safe and met people’s needs.

During the assessment the provider was transparent about ongoing recruitment and absence issues within the staff team and acknowledged they were reliant on agency staff to ensure there were enough qualified, skilled and experienced staff. An agency staff member is an individual with a contract with an employment agency rather than Pathways Health Care Limited and are hired to work at the home for short periods. Despite the provider, where possible, hiring the same agency workers to provide consistency to people living at the home, relatives and staff stated this had hindered them in building trusting relationships with people. One staff member said, “Agency staff don’t always know people’s needs and require support or need to shadow me while I support people, this takes away from my time with people.” Another staff member said, “People are safe with the number of staff we have, they may just have to wait for shower and have it on a different day which isn’t great for them.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff received training about infection prevention and control (IPC), they wore and disposed of personal protective equipment (PPE) appropriately. Pathways Health Care Limited had a dedicated domestic team which ensured good standards of hygiene and cleanliness.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. The clinical nurse manager and nursing staff involved people in changes to their medicines and ensured where appropriate their relatives where updated. The provider ensured staff received regular competency checks and these records had identified examples of good practice and areas for development. People received their medicines safely and where needed, timed medicines were safely and effectively administered in line with people’s health conditions. We observed staff administering medicines with dignity and taking time to explain people’s medicines to them. Medicine reviews and audits were completed and checks successfully identified and mitigated risks prior to errors occurring. For example, the clinical nursing manager had identified medicines no longer used were still showing as available in the providers electronic recording systems despite them being discontinued. This meant the checks and audit had identified the risk prior to anyone being at risk of receiving their medicine incorrectly