26 April 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 8 March 2018 and was announced. The provider was given 48 hours’ notice because we wanted to make sure the registered manager and staff would be available to speak with us.
The inspection team consisted of one adult social care inspector and an 'Expert by Experience'. An ‘Expert by Experience' is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection visit we reviewed the information which was held about Pathways to Opportunities. This included notifications we had received from the registered provider such as incidents which had occurred in relation to the people who were receiving care. A notification is information about important events which the service is required to send to us by law.
A Provider Information Return (PIR) was also submitted and reviewed prior to the inspection. This is information we require providers to send us at least once annually to give us key information about the service, what the service does well and improvements they plan to make. We also contacted the local healthwatch, commissioners and the local authority prior to the inspection. No concerns were raised about the service provided at the home. We used all of this information to plan how the inspection should be conducted.
During the inspection we spoke with the registered manager, the care coordinator, four members of staff, three people who were receiving care and five relatives. We also contacted health and social care professionals to seek their views, no concerns were received about the service.
During the inspection we also spent time reviewing specific records and documents. These included four care records of people who were receiving care, three staff personnel files, recruitment practices, staff training records, medication administration records and audits, complaints, accidents and incidents, policies and procedures and other records relating to the management of the service.
26 April 2018
Pathways to Opportunities is a domiciliary care agency. It supports people to live in their own homes in the community and provides personal care to people with learning disabilities and any other additional needs. At the time of the inspection the registered provider was providing support to 19 people.
At the last inspection, which took place in December 2015. The service was given a rating of 'Good'. At that time we also found one breach of the Health and Social care Act 2008 (Regulated Activities) Regulations 2014. This related to the lack of appropriate systems to record and respond to complaints. At this inspection we saw improvements had been made and the service was meeting all regulations at this time.
This inspection took place on 8 March 2018 and was announced.
At this inspection we found the service remained 'Good'. We found that these standards had been maintained and improved further. The service was very well-led. Skilled and caring staff supported people in a person centred way. Staff embraced people's diversity and this was reflected in the care plans we saw.
There was a registered manager at the time of the inspection. 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.
The registered manager was based at the office five days per week supported by a team of management personnel. There was a manager available by telephone at all times.
During this inspection we reviewed a range of care records. Care plans were detailed, consistent and contained up to date information. Risk assessments were regularly reviewed and were updated accordingly.
Medicine management systems were in place. Medicine was only administered by staff who had received the appropriate training. Regular medicine audits were taking place and people received all medicines which were prescribed for them.
People were protected from abuse and supported to make their own choices. Risks were identified and managed effectively to protect people from avoidable harm. Recruitment processes were in place to make sure that people were protected from staff being employed that were not suitable.
People received support from a staff team that was well trained and supervised. Staff had the skills and support needed to deliver care to a good standard.
People benefitted from a staff team that was caring and respectful. Staff knew each person well and worked with them in a calm, caring and professional way. People's rights to confidentiality, dignity and privacy were respected. They were enabled and encouraged to develop and maintain their independence wherever possible.
Staff told us they enjoyed working at the service and felt supported by the registered manager.
Quality assurance systems were in place and regularly carried out by both the provider and registered manager. Feedback was sought from people who used the service, staff and relatives, this information was analysed, and action plans produced when needed.
The provider continues to work in partnership with other organisations and has taken part in good practice initiatives, designed to further develop the service and support other providers to develop their services.