Clear Pathway Care

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.

Clear Pathway is a Domiciliary Care 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. There was a central office based in Ferndown.

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

People were not always protected from abuse and improper treatment. Staff had failed to prevent, identify or report abuse when providing care and support. The provider had failed to identify potential abuse or take preventative action in a timely way because the incident had not been recorded or reported by staff. Staff were not always aware of what triggers or control measures were recorded in the persons positive behaviour support plan.

The provider did not always operate a safe recruitment process. Adequate staff personnel records were not always in place. For example, full employment history and details of any health conditions relevant to staff’s capability to do the job had not been gathered or recorded for all seven staff.

Quality monitoring systems were not robust or effective. These did not cover areas where gaps were found during the inspection. The provider had failed to ensure people’s consent was sought and their rights fully protected as required by the Mental Capacity Act.

The service worked in partnership with other agencies to provide good care and treatment to people. Feedback from professionals regarding partnership working varied. Although there was a referral and admissions process in place which ensured people received pre-admission assessments before using the service, we were informed by a relative that the person’s transition had been “rushed”.

Although we were told that staff appeared kind and caring the service had not ensured a kind and caring approach was delivered by all staff working for them.

We observed the atmosphere of the home to be relaxed and engaging. The person was supported to have 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.

Medicines were managed safely and administered by trained staff. Staff listened to what the person wanted and acted quickly to support them to achieve their goals and outcomes. Staff offered the person solutions to aid their independence and develop their skills.

The staff team were motivated and there was a strong commitment to the development of their competence and knowledge. Staff worked positively to promote people’s health and ensure good outcomes for their physical and mental wellbeing.

Staff were trained and skilled. They worked with people to overcome challenges and promote their independence. Equality, Diversity and Human Rights (EDHR) were promoted and understood by staff.

The service was responsive to people’s current and changing needs. Regular reviews took place which ensured people were at the centre of their support.

Staff spoke highly about the management and staff. The registered manager, nominated individual and staff team worked together in a positive way to support the person to achieve their own goals and to be safe.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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.

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 14 March 2019 and this is the first inspection.

Why we inspected

This was a planned inspection based on the time the service first registered with us.

Enforcement

We have identified multiple breaches in relation to need for consent, safeguarding service users from abuse and improper treatment, fit and proper persons employed and quality monitoring systems at Clear Pathway.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.