Clear Pathway Care

Updated 20 November 2020

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

The inspection was carried out by one inspector.

Service and service type

This service provides care and support to people living in a supported living setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at the office and supported living setting to speak with us.

Inspection activity started on 02 November 2020 and ended on 10 November 2020. We visited the office location during the morning of 02 November 2020 and the supported living setting in the afternoon.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We reviewed information we had received about the service. This included details about incidents the provider must notify us about, such as abuse; and we sought feedback from the local authority and professionals who work with the service. We used all of this information to plan our inspection.

During the inspection

At the time of this inspection only one person was being supported. We met with the registered manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We arranged to speak with staff members by telephone to reduce the time we were on site due to the national pandemic. The person told us they were busy so we arranged to speak with them by video call after the inspection.

We reviewed a range of records. This included the person's care records and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including quality audits and health and safety checks.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, rotas, complaints management and policies. We spoke the person via video call, the registered manager, four care staff, two relatives and two professionals who had experience of working with the service. We emailed another professional for feedback so we could use this to help inform our judgements.

Updated 20 November 2020

About the service

Peartree Business Centre is a supported living service providing personal care to people with learning difficulties, autism and mental health needs. At the time of the inspection the service was providing support to one person at one location in a residential area of Poole. There was a central office based in Ferndown.

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

The service had given safeguarding a renewed emphasis since the previous inspection. Staff knew what signs and symptoms could indicate people are experiencing abuse or harm. Staff felt confident management would listen and act if they raised concerns.

There were enough staff to keep people safe and meet people’s individual needs. Staff had a good understanding of people’s individual risks and how to minimise them without being unduly restrictive. There were improved processes in place to ensure the safe recruitment of staff.

Staff understood the principles of the Mental Capacity Act 2005 (MCA 2005) and how it applied to the people there. This provided protection for people who do not have capacity to make decisions for themselves. People’s consent was consistently sought prior to support being provided.

An improved range of audits and regular checks helped ensure service quality was maintained and areas for improvement identified. Learning was shared with staff and used to develop the service.

People were supported by staff who had received the necessary training and ongoing support to help them meet their diverse needs with confidence. Staff competency was monitored on an ongoing basis through safe practice observations, regular supervision and appraisals.

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’s desire to socialise and participate in meaningful activity was met through a varied range of activities tailored to their tastes and abilities. Care included recognition and support for people’s spiritual and faith-based needs. This holistic approach enabled people to lead full and active lives.

Staff felt motivated and supported by their colleagues and the management; telling us the service was “like a family.” Senior managers had the skills, knowledge and passion to manage the service and work with people, staff and the provider to identify where it could be improved. People, relatives and staff were frequently consulted with their views used to influence what happened at the service. Feedback was unanimously positive.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, 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 providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• The model of care and service setting maximised people’s choice, control and independence

Right care:

• Care provided at the service was person-centred and promoted people’s dignity, privacy and human rights

Right culture:

• The ethos, values, attitudes and behaviours of management and care staff ensured people

using the service led confident, inclusive and empowered lives

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 02 April 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Peartree Business Centre on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.