18 August 2021
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
This inspection was carried out by two inspectors.
Service and service type
This service provides care and support to people living in two ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 2 July 2021 and ended on 13 July 2021. We visited the office location on 2 July 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.
During the inspection
We spoke with two people who used the service and four relatives about their experience of the care provided. We spoke with eight members of staff including the registered manager, team leaders and support workers.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We received feedback from two professionals who work with the service.
18 August 2021
About the service
Dillan Care Pathway provides personal care to people across two supported living locations; one in Barnet and one in Harrow. At the time of the inspection, 14 young adults over the age of 18 with a learning disability, were using the service, all of whom receive personal care. Some people who used the service also had a physical and/or sensory disability.
People’s experience of using this service and what we found
Improvements had been made to the service since our last inspection. People told us they liked living at Dillan Care Pathway and led active and social lives. People received their medicines as prescribed. Staff were safely recruited, and staffing levels were sufficient.
Where risks to people had been identified, staff responded to these by following guidance in people's care plans. Staff knew people well and as such they were able to tell us about how they kept people safe.
The management team monitored the quality of the service provided to help ensure people received safe and effective care. This included seeking and responding to feedback from people in relation to the standard of care. The management made regular checks on all aspects of care provision and actions were taken to continuously improve people's experience of care.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
Based on our review of key questions Safe, Responsive and Well-led, the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
• Model of care and setting maximises people’s choice, control and independence. People were supported to have maximum choice and control over their lives to enable them to live their life to the full.
• Care is person-centred and promotes people’s dignity, privacy and human rights. People were supported in a positive way to enable them to live as independently as possible.
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. The management team and staff had a positive impact on people's wellbeing, confidence and quality of life.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was Requires Improvement (report published 20 August 2019)
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made.
Why we inspected
We carried out an announced comprehensive inspection of this service on 3 July 2019. No breaches of legal requirements were found however we identified the provider needed to make improvements with regards to staff recruitment and overall governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
We undertook this focused inspection to check improvements had been made. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Dillan Care Pathway on our website at www.cqc.org.uk.
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.