Pathway House

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last inspection we rated this key question Good. At this inspection the rating has changed to Outstanding. This meant people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.

Staff were incredibly kind, caring and supportive and were committed to supporting people to live the way they wanted to. People were fully in control of their care and support and staff prioritised supporting them to be as independent as they chose to be. There was a focus on treating people as individuals and focusing in on how best to support them with their own personal preferences, likes and dislikes. The positive outcomes people had been supported to achieve as a result of staff support were excellent.

This service scored 95 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Without exception, people and their relatives spoke positively about their/ their family members support and the kind and caring nature of the staff team. Staff spoke about people knowledgably and with kindness and compassion. They always made sure people were happy with what was happening and how they were being supported.

The kind, caring and compassionate support staff gave to people had resulted in them being able to successfully live at the service for extended periods of time. This had not been possible for people in the past. Staff were incredibly knowledgeable about how to be kind and compassionate when people were feeling upset or anxious. People were living with very specific support needs, including how they showed how they were feeling when they felt upset or anxious. In the past, people had needed support with this in the form of physical support from staff members or through the use of PRN medicines, which helped them feel calmer. For all the people living at the service, the need to use physical support or medicines had reduced significantly. This was because of the way staff supported people in a kind and respectful way when they felt upset, using words and language to help people feel calmer and giving them the space to feel better. The massive positive benefits for people not needing to be supported with restrictive practices as a result of this were amazing. People were now very happy and relaxed living at the service. One relative said, ‘‘[Family member] has come on leaps and bounds. Doing a lot more. They are using public transport and going on trains. They have a much better quality of life. When we see them they are visibly happy and smiling. They are very trusting of the staff. The atmosphere is very good and relaxed.’’

One of the providers key values was treating people with dignity and staff fully understood and embraced this value. People took part in activities that were very personal to them but still needed support from staff to take part in this. This had been fully supported by the management and staff team who handled this delicately and respectfully, fully supporting people to take part in these activities in a dignified way. We were shown multiple pieces of evidence showing the massive positive impact this had for people. Staff had also taken the time to make ‘profiles’ about themselves including what their preferences were and what was important to them. These were shared and on display for people so they could share in the understanding of how important being kind and compassionate to each other is.

We observed staff speaking with people with kindness and compassion. People, who found it difficult to ask for support or interaction, felt very comfortable, happy and relaxed around the staff team. One person had learnt staff members names, which is something they had not done before. This was a hugely positive achievement for the person. Staff spoke about people with kindness and clearly had their best interests at heart. A relative said, ‘‘[Family member] has great relationships with the staff team and he is going out and about a lot and is generally just a lot happier. I am very happy with the service.’’

The provider always treated people as individuals and made sure people’s care, support and treatment met people’s specific needs and preferences. Staff knew people extremely well as individuals and knew how they liked to be supported.

One of the providers key values was treating each person using the service as unique and as an individual. This was fully understood and embraced by the management and staff team. A significant amount of attention and detail had been given to spending time with people to fully identify their individual support needs and preferences. This had resulted in people’s support being very individualised and specific to their needs and preferences.

Staff had spent time with people and worked out what their preferences were and how they liked to spend their time. By speaking with people in ways that made sense to them and taking small steps, people’s individual preferences had been fully supported. People were living full and fulfilled lives and had been supported to spend their time doing what they had chosen to do. This includes visiting the local community for areas of interest, playing golf, visiting beaches, using public transport and accessing resources such as the gym. This had been very difficult for people in the past and had not been supported. However, thanks to the outstanding support of the management and staff team, people were being fully supported as individuals. We observed staff speaking with people and using language in different ways depending on the persons individual needs to encourage them to take part in daily living skills or to explain what was happening. People were receptive to this and as a result happily took part in all aspects of their lives. A relative said, ‘‘Staff are always very nice and good relationships. I get on with the manager. My family member has complex needs, and it has taken staff a while to get used to them. They understand their needs, and they are very settled. They refer to it as their home.’’

As a result of being supported as individuals people had been supported to have positive experiences. For example, one person had found it difficult to maintain a relationship with their family. Thanks to staff support they now enjoyed seeing their family members and looked forward to this. This had a positive impact for the person and their family. Another person was living with a health condition which used to have a large impact on their life, if they felt bored or overstimulated. Staff support and being busy with their individual preferences had meant the health condition now had a very minimal impact on the persons life.

Newer staff at the service were surprised when they had read about how people used to show how they were feeling when they were angry and the challenges people used to have when taking part in daily living skills and accessing the community. This was because people were so happy and relaxed living at the service, they no longer needed to show how they were feeling in ways that may hurt themselves or others and no longer found it challenging to leave the service. The difference this had made to people’s lives was extraordinary. The registered manager said, ‘‘When I first started here, the first thing I needed to do was put people first. We [the management and staff team] have worked hard to make sure they have the best experiences they can have and this is reflected in everything we do. The fewer incidents and the amount of time people are spending out and about or being busy at home is very different to where it was a few years ago.’’

Staff always supported people to be independent if they chose to do this. People were supported to be fully in control and make choices about all aspects of their care.

The management and staff team fully understood that in order to support people in the best way possible, people had to be in control of their support and make choices in all aspects of their lives. Staff offered people choices on a continuous basis as they were supported. However, staff had worked intensively with people to make wider choices about their care and support. Every person had been supported to identify and make choices about how they wanted to spend their time in and out of the house. These had been used to form ‘timetables’ for people so they knew what they were going to be doing and every effort was made to make sure these ‘activities’ happened when people chose them to. One person said, ‘‘I am always busy. The staff help me out.’’

By fully encouraging people to make choices and being patient and respectful of these, staff had successfully supported people to have a wider range of experiences than what they had in the past. Staff empowered them to fully be in control of these choices which led to a wider range of experiences for people and positive outcomes. One relative said, ‘‘By giving [family member] the choice about how they are supported the staff have helped them be so much happier and more settled. They have lost weight and are always calm and happy.’’

Staff supported people to be independent by fully respecting their space and choices whether to be independent or not. By using this approach people had been supported to increase their independent living skills drastically. This included in areas such as cooking, cleaning and shopping in the community. This had not been possible for people in the past. One person had wanted to cook for some time but found this quite challenging due to the overstimulation this caused them. Staff had confidently worked with the person slowly taking small steps and taking positive risks. The person had successfully cooked several meals and pictorial evidence showed the massive positive impact this had for them. We observed people throughout the day independently cooking with staff members and cleaning their house. The significant process people had made in relation to their independence thanks to staff support was incredible. A relative said, ‘‘[Staff] make every effort to support [family member] to be involved in everything that is going on. It has been a difficult road but the progress that has been made is great and has meant a lot both to [family member] and to us.’’

Staff always responded to people’s immediate needs. People never had to wait for support when they asked for it and staff were always on hand to support people.

The ways in which staff responded to people’s immediate needs was exceptional. People had specific staffing requirements both inside and outside of the house. It was very important to people to be in control of when they left the service. The correct number of staff needed to be available to support the people when they chose to leave the service, as soon as they wanted to leave to support them to do this in line with their choices and preferences. This was always the case. As a result, people had been fully supported to increase the amount of time they spent going out in the community and were also able to do what they wanted immediately when they chose to do so. The management team had organised the staffing levels to support with this.

Staff knew people very well and recognised changes in their support needs immediately. This meant changes could be made to support people with their immediate needs. For example, one person had started to feel more anxious and speak with staff about certain subjects more often. Staff noticed this straight away and were able to get support from the relevant professionals to help support the person. The person was able to feel better immediately as a result of this.

We observed people did not need to wait for support when they needed it from the staff team. As a result people felt safe and comfortable having their needs met very promptly. The way in which people’s immediate needs had been supported had led to people feeling safe and comfortable and achieve great outcomes. These have been detailed throughout the report.

The provider cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care. Staff enjoyed working at the service and felt well supported by the management team. They had regular discussions and supervisions to discuss their job roles and any support they may need. This was reflected in the outstanding ways they supported people as discussed throughout this report.