Pathway to Care

Updated 17 May 2022

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 Care Act 2014.

Inspection team

This inspection was completed by one inspector.

Service and service type

Pathway to Care Limited is a domiciliary care agency. It provides personal care to people living in their own houses, flats and specialist housing in Derby. At the time of the inspection the service were supporting twelve service users. There was a registered manager at the time of this inspection. The registered manager was also the provider. Both roles 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 one day's notice of the inspection. This was because we wanted to speak with people and their relatives and care staff; we needed to be sure that the registered manager would be in the office to support the inspection.

Inspection activity started on 4 April 2022 and ended on 7 April 2022. Phone calls were made to people and their relatives and staff on 5 April 2022. We visited the office location on 4 April 2022. We continued to review evidence the registered manager sent us until the 7 April 2022.

What we did before the inspection

We used information received about the service since it registered with the Commission. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We reviewed a range of records including the relevant sections of three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. We reviewed other records related to the management of the service, including policies, training records and audits.

We spoke with three people and three relatives of people who used the care service. We spoke with the registered manager and three care staff.

What we did after the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 17 May 2022

About the service

Pathway to Care Limited is a domiciliary care service. It provides care for people living in their own houses and flats. People are supported in their own homes so that they can live as independently as possible. CQC regulates the personal care and support. There were twelve people who received personal care at the time of the inspection. 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

Records were not always available to show care staff had been recruited in line with the provider’s policy and potential risks had not always been identified and risk assessed. Care plans were not always up to date and some risk assessments had not been completed. Records were not always accurate, complete or up to date. Audits had not always been effective at identifying shortfalls and ensuring improvements were made.

Staff had their competence to meet people’s needs assessed. Staff had enough time to travel to people’s homes and provide their care. People knew the care staff that provided them with care. Medicines were managed safely and staff knew what action to take to help prevent and control infection. Systems were in place to safeguard people from abuse.

People were supported to have maximum choice and control of their lives and care 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 staff worked effectively with other health care professionals to help people live healthier lives. People and relatives said care staff understood their care needs and assessments reflected their needs and choices. Staff had received training in areas relevant to people’s health and care needs.

Care staff worked in ways to promote people’s independence. People’s privacy and dignity was respected. People were asked their views about their care and were involved in decision making. Care staff were described as friendly, caring and cheerful.

Care staff worked flexibility so that people received personalised and responsive care. People and relatives told us they had positive relationships with care staff and enjoyed sharing time together. People had their communication needs assessed to ensure any needs could be met. Processes were in place to manage and investigate complaints and concerns.

Policies and procedures were in place and covered areas of governance and management including the duty of candour. Accident and incidents were reported and investigated to help identify any lessons learnt and to identify any further risk reduction measures needed. The registered manager led with an open and approachable management style and worked well in partnership with others.

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

Rating at last inspection

This service was registered with us on 5 August 2019 and this is the first inspection.

Why we inspected

This was a planned inspection based on the date of registration.

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.