We carried out a review of the data available to us about Adult Pathways 2 on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Adult Pathways 2, you can give feedback on this service.
Education & Life Skills - Warford is a residential care home that was providing personal care and accommodation for 18 people in two adapted ‘houses’ at the time of the inspection. The service specialises in supporting younger adults who have a learning disability or are autistic. Most of the people using the service were also students at the provider’s school and specialist college on the same site.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.
People’s experience of using this service and what we found
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement. As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
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.
People were supported by a team of safely recruited, trained and experienced staff. People's received their medicines when they needed them, and their healthcare needs were met. People also benefitted from having access to support from a range of healthcare professionals and therapists who worked on site.
People were supported to access and participate in a range of activities, sports and pastimes they enjoyed. People were supported to meet people, socialise and try new things.
People were relaxed in the company of staff and each other. Relatives felt staff had a good understanding of their loved one's needs and how to communicate with them effectively.
People received the support they needed to eat a balanced diet that met their needs and preferences. Mealtimes were flexible and varied according to individual needs and commitments.
People’s needs had been assessed and planned for before they moved into the service. This helped to ensure that people received planned and co-ordinated person-centred support.
The registered manager and house managers had a good understanding of their roles and responsibilities and of people’s needs. There were systems in place to assess the quality of the service people received and bring about improvements. Relatives and staff felt the service was managed well.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection: Good (published 7 April 2017)
Why we inspected:
This was a planned inspection based on the previous rating.
We will continue to monitor the information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.
The Education & Life Skills service supports young people with complex needs to attain quality of life and to maximise their potential in a safe residential environment. Accommodation is provided in a number of houses, namely Redwood, Limes, Hawthorns, Brambles and Rowans, all based on The David Lewis Centre site in rural Warford. At the time of our inspection there were 28 people using the service. People using the service are referred to as students.
The last inspection took place on the 22 January 2014 and we found at that time that all the legal requirements were met.
The service has a registered manager. 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.
During this inspection we found that the service was well organised and managed, ensuring that risks to people using the service were regularly reported on and analysed.
A number of the students presented with particular risks in respect of their behaviour and staff worked closely as part of a multi disciplinary team to manage incidents safely and learn any lessons arising from them.
Staff feedback throughout the inspection was that at times the service was short staffed. Further information following the inspection has confirmed that more staff have since been recruited and the registered manager had taken steps to address issues around short term absence. Training was seen as being of extreme importance and new staff had access to a comprehensive induction programme.
Staff were very aware of the need to gain consent from people using the service. Staff had developed positive caring relationships with students and as a consequence this fostered a relaxed atmosphere.
Records of all the care and medical interventions people received were held electronically and there were good systems in place for updating them and ensuring they were accurate.
The registered provider had a number of systems in place to ensure the quality of the service.
We looked at five care files in relation to consent issues for people who used the service and all of these contained information which demonstrated that consent issues had been explored and were dealt with appropriately.
The people we spoke to who were living at the Centre told us they were happy and that staff looked after them well. One person told us; 'Staff are great.'
The people we spoke to who were living at the Centre, told us they felt safe. One person said; 'I always feel safe here.'
We looked at the annual 'College residential satisfaction survey.' We saw that there were high levels of satisfaction recorded from the respondents in all areas surveyed.
We looked at policies, risk assessments, capacity assessments, surveys, minutes of meetings and training information. Documentation was clear, detailed and consistent with the provider's other locations.
During the day we spent on the campus we saw that at all times staff treated people kindly, with respect and ensured their dignity. We saw that a good deal of effort was made to involve everyone in their care plans in some way or other and when this was not possible account was taken of the views of their relatives.
Everyone had their particular care needs assessed and the plans developed from this were detailed, regularly reviewed and adhered to. People's health needs were assessed, developed into their care plans and their health was monitored. Risk assessments to protect people from harm were comprehensive and where possible involved the person being cared for.
Food was mostly prepared in each house and we saw that the kitchens were well equipped and stocked with ingredients. People were involved in the planning and preparation of their food as appropriate to their abilities. When needed people had special diets that took account of their health needs and these were developed with health professionals and adhered to.
Thorough staff recruitment and training procedures were in place
The provider had an appropriate complaints policy and when we looked at a sample of complaints we saw that they had been properly investigated.
There were 70 young people living at David Lewis Education and Life Skills when we visited. We met over forty young people. Some young people we met had some communication difficulties and we observed how staff supported them. Other young people chatted to us. One young person said, 'I decided I wanted to live here straight after visiting.' Another young person said, 'I like it here and have friends' and 'Staff make me feel good about myself.'
As the Education and Life Skills part of the service shares the same campus as the Pathways and Community part of the service, it was not always clear, which part of the service the young people we met around the grounds were accessing. However all the people we spoke with told us that they liked being at David Lewis.
We also spoke with several relatives. They were all pleased with the care provided and said that staff were kind and helpful to their family member and that staff supported their family member well. Comments from relatives included:
'I can't fault David Lewis' and 'Our son is having a good time.
'David Lewis is an excellent placement.'
'We know in our hearts that David Lewis is the right place for our daughter', adding that 'She can't wait to get back there when returning from home, which tells us everything'.
Parents were happy with the way the young people were supported and felt each person was treated as an individual. One parent said 'it was all about our son's needs' and 'they see the whole person'. Another parent said, 'David Lewis staff already know our son, and the standard of care is very high' adding 'David Lewis are tuned in to him and his needs'.