Pathways to Opportunities

Updated 5 October 2023

The inspection

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 1 inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses, flats, and specialist housing.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave a short period notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 30 August 2023 and ended on 11 September 2023. We visited the location’s office on 31 August 2023.

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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 1 person who used the service and 3 relatives about their experience of the care provided. We spoke with 8 members of staff including the registered manager, care co-ordinators, seniors, care workers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 3 people’s care records and multiple medication records. We looked at records in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

Updated 5 October 2023

About the service

Pathways to Opportunities is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older people and younger adults with various needs, including people with learning disabilities. At the time of this inspection 12 people were using the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

People received good quality care. 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. Care plans were detailed and person-centred. The care plans provided guidance for staff about how best to support people's needs and preferences, and the outcomes to be achieved. People and relatives were involved in the care planning and regular reviews. Staff knew and understood people extremely well which led to good outcomes for people.

Right Care:

People received person-centred care of a high standard. People received kind and compassionate care. Everyone we spoke to as part of the inspection praised the service. Staff were kind, caring and understanding. Staff treated people with dignity and respect. Staff understood and responded to people’s individual needs. People's care needs were risk assessed and care plans provided staff with the information they needed to manage identified risks. People were protected from the risks of abuse and staff were trusted to keep them safe. Staff had received training in how to safeguard people. Medicines were managed safely, however, we have made recommendations about the provider reviewing their ‘as required’ (PRN) medicines systems and reviewing the frequency of staff medicine competency assessments.

Right Culture:

The culture of the service was friendly, open and transparent. The registered manager had clear values which included a passion for providing a high standard of care to people. These values were embedded into the service and staff members we spoke with. The registered manager and staff demonstrated a commitment to people, and they displayed person-centred values. People's choices were respected, and staff supported them to achieve good outcomes. The culture was open and inclusive. Staff said they enjoyed their roles and the relationships between staff and people was positive. Auditing systems were in place that enabled the registered managers to have effective oversight of the service and identify and respond to any improvements needed. People told us they felt safe and knew how to raise concerns.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

The last rating for this service was good (published 25 April 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Recommendations

We have made recommendations about the provider reviewing their ‘as required’ (PRN) medicines systems and reviewing the frequency of staff medicine competency assessments.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.