Adult Pathways 1

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to Good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 82 (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 very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities. The provider described their mission was to, ‘Provide an excellent service to individuals with learning disabilities, supporting the meaningful fulfilment of their lives and the achievement of their aspirations’. The provider aimed to do this by, ‘Enabling individuals to gain independence, positive identity, self-esteem and personal control over their lives via specialised support packages delivered in a variety of community locations’. Throughout our assessment we observed multiple examples when the provider had put this into practice and produced many positive outcomes for people.

For example, the provider was committed to removing and reducing restrictions in place for people’s safety and was working actively with people to achieve this.

Strong links had been formed by the provider with local employers which had resulted in paid employment opportunities for people as well as work experience placements where people could learn new skills.

A strong focus had been placed on developing co-production within the service to ensure people had a voice and could influence providers decision making at a strategic level.

The provider had heavily invested in transforming the accommodation at the David Lewis Centre and this was having a direct positive impact on the people supported within Adult Pathways 1. Some people were looking forward to developing greater independence through improved living environments and improved modern facilities. One person told us they were in the middle of choosing new decoration and was looking forward to the move. A family member told us this would be beneficial to their loved one as it would create a smaller and consistent staff team who could best meet the person’s needs.

People and their families felt part of a community and without exception feedback was overwhelmingly positive about the care people received. For example, family members told us, “We can relax as we know [Name] is receiving the best care possible enabling her to reach little milestones that we would never have thought possible” and “There is nowhere like David Lewis. It has a community ethos. [Name] calls it her second home, and all staff and her peers are like family to her and us.”

The provider recognised the importance of involving and engaging staff in the delivery of the organisations strategic plan and goals. The chief executive provided regular updates to staff and provided examples of how their work contributed to the overall vision.

Staff spoke with pride about working for the provider and with fondness of the people they supported and would all recommend the service to others. Staff feedback included, “I love what I'm doing” and “It’s a great place to work.”

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty. Staff felt well supported and leaders were described as, “Supportive and approachable.” One staff told us, “I feel supported by [the registered manager].” Staff had access to a leadership team who were on-site throughout the day and night so staff could access support and advice. A staff member said, “We can call any manager if we need to. There will always be someone here.”

The registered manager and entire leadership team were very open and receptive to feedback throughout our assessment. Detailed updates were provided to demonstrate action taken in response to any feedback given.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Systems were in place to ensure people who spoke up were supported and staff told us they felt confident to raise any concerns with the registered manager. One staff commented, “I feel comfortable to question practice. It is very open and honest here at David Lewis.”

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. Policies were in place to support this.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. Checks had not picked up on the shortfalls within risk assessments, care plans and care monitoring records we identified. We were assured however, no harm had occurred to people, and immediate action was taken to respond to the issues raised.

The provider did have systems in place to review and check on people’s views and to observe the quality of care people received. This was through a mixture of visits to the individual households by senior leaders and trustees of the organisation. External agencies were enlisted to complete this work.

The registered manager understood their responsibility for notifying the CQC and other agencies of events which occurred within the service and accurate records were maintained. When things had gone wrong the registered manager had demonstrated an understanding of their responsibility under duty of candour.

The provider clearly understood and carried out their duty to collaborate and worked in partnership, and services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement.

We saw multiple examples of close collaboration with other agencies. For example, the provider had worked with a local university to develop a virtual map of the campus. This was developed to support new people who were planning to attend either a service provided on site or join a residential service. This virtual map enabled people to travel round the site and visit some of the key facilities with the aim of reducing potential anxieties. The provider demonstrated a clear commitment to engaging meaningfully with family members to support this and had facilitated setting up a ‘family buddy system’ where prospective family members could seek advice and peer support from families of people already supported. This enabled prospective families to talk about any concerns or seek advice from people with lived experience of the provider.

Other collaborations and partnership working initiatives were focused on creating and improving opportunities and experiences for people to access employment and work experience opportunities. For example, some people were volunteering at a local farm. Other people were working in local business including a nearby football club and a large employer within the local area and receiving paid salaries. We read examples of how they made this successful by supporting people to develop one-page profiles to assist the employer and work colleagues to understand what would get the best out of people as well as saw genuine examples of success stories where people were positively recognised in their workplace by colleagues for their contributions. One external partner told us, “From my perspective, partnership working is very positive. Communication is clear and timely, and there are well-established procedures in place which enable me to work effectively with [the service].”

The provider had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people.

The provider had a demonstrable commitment to co-production with people across the David Lewis Centre and people’s families. Through co-production the provider had an established ‘peoples council’. This consisted of people who received support who were voted in by their peers for a fixed period. One family member told us their loved one was very proud of their role and said it, “Gives service users the opportunity to put forward their ideas and improve the service they receive which in itself makes [Name] feel valued and is growing in confidence.” Once a person had served their time on the council, they were invited to be an ‘Elder’ who worked directly with the senior leadership team to influence decisions made at a strategic level. This was a new initiative and one person was very proud of this achievement and explained they had their own email account which they used to communicate directly with senior leaders.

Several positive outcomes were shared with us through the assessment. Amongst these was the establishment of the on-site radio station where shows were co-produced and presented by people. Special guests were invited onto the shows, and it was a useful method for the provider to share news and information. People involved had the opportunity to receive specialist training and guidance from a local radio station.

People had voiced to the council they wanted to create a Christmas advert. The finished product was written, acted and produced by people who used the service. People, and staff were very proud of this and keen to showcase their achievement.

One person had attended a provider engagement event to talk about their life and had been invited to a national conference which they were looking forward to.

Another person had delivered training to the local hospital accident and emergency department to raise awareness of the needs of people with a learning disability and autistic people when requiring emergency medical care. Professionals told us this had helped to improve the practice of student nurses through a greater understanding after hearing about peoples lived experiences.

The provider co-production lead was passionate about their role. They explained they had introduced additional groups for people to become engaged based upon their interests and hobbies. For example, there was an art group, a media group and a group for people interested in recruitment of staff. They aimed to encourage interest through common purpose and promote discussion about key topics whilst participating in activities people enjoy and explained this was being continually developed and improved.

The provider had actively contributed to safe, effective practice and research. Through collaboration with a local university, the provider was working to produce a new model of care delivery which aimed to reduce restrictive practices as well as undertaking a research piece to develop a quality framework alongside other providers who provided care and support through a campus setting.