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Pathfields Lodge Requires improvement

The provider of this service changed - see old profile


Inspection carried out on 16 May 2019

During a routine inspection

About the service: Pathfields Lodge is a residential care home that was providing personal and nursing care to 30 people at the time of the inspection.

People’s experience of using this service.

Checks and records made during recruitment processes were insufficient and did not evidence that staff were safe to work with vulnerable people.

People were exposed to the risk of harm in a number of areas around the building.

Systems of governance and oversight were not sufficiently robust to have identified the issues we found in relation to recruitment and environmental safety.

Care plans were not well-organised and did not always contain accurate or up to date information. This made it difficult to find important details about people’s needs.

In line with the Mental Capacity Act, people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service didn’t always (consistently) apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people did not fully reflect the principles and values of Registering the Right Support due to a lack of choice and control and limited inclusion in care planning.

People and relatives were happy with the service they received. We were told.”I’d be very happy to recommend Pathfields to anyone looking for a nursing home for their family,” and "I have nothing but praise for my relative's carers.”

People, relatives and staff spoke positively about the registered manager and felt able to raise concerns and were confident that these would be addressed.

Staff received varied training to enable them to carry out their roles effectively.

Staff enjoyed working at the service and felt supported by each other and the registered manager. We were told, ”It’s a good team,” and “[Manager] is very supportive.”

When there were complaints or concerns, the registered manager dealt with them appropriately and put measures in place to reduce the likelihood of recurrence.

The registered manager recognised the importance of retaining staff and was keen to improve the service and promote good practice.

Rating at last inspection. Rated good, report published 3 November 2016.

Why we inspected:. This was a scheduled inspection based on the rating at the last inspection

Enforcement. At this inspection, we found the service to be in breach of three regulations of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014.

Follow up. We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at

Inspection carried out on 16 September 2016

During a routine inspection

Pathfields Lodge is registered to provide care for up to 48 people with learning and physical disabilities and people living with dementia. At the time of our inspection the registered manager informed us that 31 people were using the service.

The inspection took place on 16 September 2016 and it was unannounced, further documentation to complete the inspection was received from the provider on 20 September 2016.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were protected from the risks of abuse. Staff understood what constituted abuse and the safeguarding procedures to follow to report abuse both internally and externally. People were supported to express their autonomy and make informed choices when taking risks.

Staff were employed following safe and robust recruitment procedures. There was sufficient numbers of suitable staff to meet people's assessed needs. Staff received appropriate training to ensure they were equipped with the right skills and knowledge to support people using the service. Staff supervision systems ensured that staff had regular supervision meetings to reflect on their work practice and plan their learning and development needs.

Suitable systems were in place to safely manage medicines. Medication risk assessments took into account people's capabilities to manage their own medicines and when staff needed to take on the responsibility. Regular medicines audits ensured that any areas for improvement were identified and action was taken to address them.

People's consent was sought before staff provided their care. People who lacked capacity to make decisions were supported following the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People had a balanced and varied diet and their dietary needs were assessed and monitored. They had regular access to healthcare professionals and were supported to attend health appointments to ensure their health and well-being needs were met.

Staff treated people with kindness, compassion, dignity and respect. Independence was promoted and people were enabled to make and maintain relationships. Individualised care plans were in place that reflected people's needs and choices on how they wanted their care and support to be provided.

People and their representatives were encouraged to provide feedback on the service and their views were listened to and acted upon. Suitable arrangements were in place to receive and respond to complaints.

The vision and values of the service were person-centred. People and their representatives were supported to be involved and in control of their care.

Suitable governance and quality assurance management systems were in place to monitor all aspects of the service provision.