Archived: Independent Living Pathways

Updated 3 February 2016

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.

This inspection took place on 25 and 30 November 2015 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service.

The inspection team consisted of one inspector and an expert by experience who had a direct knowledge of metal health services. 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 our inspection we reviewed the information we held about the home. We considered information we held about the service this included safeguarding alerts that had been made and notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law.

On this occasion we did not ask the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also spoke to a commissioner of care from the local authority before the inspection.

During the inspection we were able to talk with six people who used the service. We also spoke with four staff members, the registered manager and a visiting social care professional. Following the inspection we spoke with a further social care professional and a health care professional.

We observed care and support in communal areas and spent time in the DCA office and listened to a staff handover.

We reviewed a variety of documents which included people’s care plans, three staff files, training information, medicines records, audits and some policies and procedures in relation to the running of the service.

We ‘pathway tracked’ two people who used the service. This is when we looked at people’s care documentation in depth, obtained their family views on how they described the care at the service and made observations of the support they were given. It is an important part of our inspection, as it allowed us to capture information about people receiving care.

Updated 3 February 2016

Independent Living Pathways provides care and support through a Domiciliary Care Agency (DCA) to adults with mental health problems who live in leased accommodation with tenancy agreements. These adults live in supported living accommodation and have tailored support packages with an aim to promote more independent living within the community. At the time of this inspection seven people were receiving care and support from the DCA.

This inspection took place on and 25 and 30 November 2015 and was announced with 48 hour notice given.

The service had 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.

The quality monitoring systems and governance systems needed further development to ensure they were used to identify shortfalls and demonstrate effective responses. This included robust recruitment practice for staff.

People were cared for by staff who had not all been recruited through safe procedures. Recruitment checks such as two written references had not always been received prior to new staff working in the service.

The provider was not consistently operating the service in line with their registration requirements. Tenancy agreements were not clear that care and support were provided separately from the accommodation, as required for supported living. The operation of the service was also being conducted from an office which was not registered. We were advised a suitable application had been submitted to address this matter.

People's individual care and support needs were assessed before they were provided with a service. Care and support provided was personalised and based on the identified needs of each individual. People were supported to develop their life skills and increase their independence. People, where possible, were supported to move onto further accommodation where they could be more independent, for example into their own flat. People’s care and support plans and risk assessments were detailed and reviewed regularly. People told us they had felt involved and listened to.

People were supported to access health care professionals routinely and as required as a result of changes in health. Staff were aware of the processes they needed to follow to raise concerns about people’s health. All appointments with, or visits by, health care professionals were recorded in individual care plans. There were procedures in place to ensure the safe administration of medicines. People were supported to take their medicines and increase their independence within a risk management framework.

There were sufficient numbers of suitable staff to keep people safe and meet their care and support needs. The number of staff on duty had enabled people to be supported to attend educational courses, day care, social activities and to develop their life skills to become more independent. People felt well supported, and were encouraged to be as independent as possible. We observed friendly and genuine relationships had developed between people and staff. People spoke positively about the registered manager and said that they could approach them about any issues they wanted to.

Staff told us they were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. Training records were kept up-to-date, plans were in place to promote good practice and develop the knowledge and skills of staff. Staff demonstrated a good understanding of safeguarding procedures.

There were systems in place to monitor the quality of the service which included satisfaction surveys and meetings with staff and people who used the service.