CQC report explained · a residential care home
What the CQC found at Adult Pathways 2
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough safely recruited and experienced staff, detailed risk assessments, safe medicines practice and clean, well-maintained areas.
- Effective?
- Good
- People received support based on detailed assessments, had access to healthcare professionals and were supported with food, training and daily living needs.
- Caring?
- Good
- Staff knew people well, supported their choices and independence, and helped them maintain family relationships.
- Responsive?
- Good
- Care plans were personalised and reviewed. People had communication tools and information in formats they could understand, and were supported with hobbies, social activities and relationships.
- Well-led?
- Good
- Managers understood their responsibilities and relatives and staff felt the home was well managed. Quality checks, incident reviews and complaints monitoring were in place.
What inspectors found, December 2019
Education & Life Skills - Warford was rated Good; inspectors found safe, kind and personalised care across all five areas.
The inspection took place on 8 and 17 October 2019. One inspector and an Expert by Experience spoke with people, staff and relatives, observed care, and checked care, medicines, recruitment and management records.
The home was supporting 18 younger adults with learning disabilities or autism. Inspectors found that people were safe, received their medicines and healthcare, and were supported by trained and experienced staff.
People were treated with kindness and respect. They were supported to make choices, build independence, communicate in ways that suited them, join activities and maintain relationships.
The home was rated Good in Safe, Effective, Caring, Responsive and Well-led. This was the same overall rating and the same rating in each area as at the previous inspection, published on 7 April 2017.
Safe staffing and medicines
Inspectors found enough safely recruited and experienced staff. Medicines were given on time and records were complete.
“People received their medicines on time from appropriately trained staff.” from the report
Personalised care
Care plans included people's needs, preferences and goals, with involvement from people, relatives and healthcare professionals.
“Care plans were detailed and had been developed with the involvement of the person, their relatives and where appropriate health care professionals involved in their care.” from the report
Choice and independence
People were supported to make choices, take part in daily tasks and become more independent.
“People were encouraged to be independent and as far as possible and complete daily living tasks such as laundry and cleaning, themselves.” from the report
Activities and relationships
People were supported to enjoy hobbies, try new things, use community facilities and keep in touch with people who mattered to them.
“People were supported to participate in their hobbies and interests and to try new things.” from the report
Approachable management
Relatives and staff described the management as supportive and approachable. The home had systems for monitoring quality and learning from incidents.
“The (house) manager is excellent, very approachable and understanding, lots of empathy.” from the report
Inspectors raised no specific concerns in this report.
- 01The report says some restrictive interventions were used as a last resort. In what situations might these be used for my relative, and how are they recorded and reviewed?
- 02Most people were assessed as needing one-to-one or two-to-one support. What level of staffing would my relative receive, and how is this maintained when staff are absent?
- 03How would my relative be involved in choosing meals and communicating their food preferences?
- 04What communication tools and accessible information would be used for my relative's needs?
- 05How would my relative's care plan, goals and progress be reviewed with us and with relevant healthcare professionals?
This was a planned inspection covering all five CQC questions, with care, medicines, staffing, records, activities and management systems reviewed; nobody at the time was receiving end-of-life care. This explanation was written from the published report of 6 December 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, April 2017
Adult Pathways 2 was rated Good; inspectors found caring, safe and well-organised support, with some staffing and record-keeping issues.
The inspection was unannounced at first and continued over five days. Inspectors reviewed care records, staff files, training, rotas, safety checks and complaints. They spoke with staff and families, observed people receiving care, and visited the different homes.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found thorough recruitment, safe medicines management, detailed care and behaviour support plans, good training, respectful staff and strong quality checks.
There were some shortfalls. Staff said the homes were sometimes short staffed, which could restrict access to activities outside the site. Some care records had not been transferred to the electronic system, and inspectors raised questions about oversight of safeguarding information and whether staff always followed behaviour support plans.
The previous inspection in January 2014 found that all legal requirements were met. After this inspection, the manager said more staff had been recruited and staffing had reached 104% of the planned establishment.
Kind and respectful care
Inspectors saw staff building positive relationships and treating students with patience, respect and dignity.
“All the staff were extremely respectful and patient, giving students time to respond and having a laugh and joke with them.” from the report
Detailed care planning
Care plans and risk assessments described people's needs, communication, routines and behaviour support strategies in detail.
“Care plans were held electronically on the ICare system and provided comprehensive information in respect of general health care needs.” from the report
Safe medicines and recruitment
Only trained staff administered medicines, and recruitment checks were thorough.
“Medicines were only administered by staff trained to do so and were found to be stored and recorded appropriately and safely.” from the report
Staff training
New staff received a substantial induction, with further training, supervision and team support.
“Staff described their 17 day induction training and one member of staff told us it had allowed them to develop their confidence” from the report
Electronic records not always current
needs fixingSome paper support plans had not been transferred to the electronic system, so records were not always completely up to date.
“We did note that in some cases the records on ICare were not completely up to date” from the report
Staffing pressure affected activities
needs fixingStaff reported periods of staff shortage. Inspectors were told that people could not always take part in activities outside the site as they would have liked.
“Staff did tell us that at times because of staffing levels, students could not always access activities external to The David Lewis Centre in the way that they would like.” from the report
Safeguarding oversight
needs fixingInspectors questioned an arrangement where the organisation's own safeguarding lead initially assessed concerns before deciding whether to refer them to the local authority. A weekly log was later agreed with the local authority.
“We found that this arrangement had not been reviewed for some time and did raise some questions about how transparent and robust the scrutiny of any incidents may be.” from the report
Following behaviour support plans
needs fixingInspectors found that staff had not always followed people's positive behaviour support plans. Further training and reminders were introduced.
“Findings from investigations sometimes showed that incidents had occurred because staff had not correctly followed the student's positive behavioural support plan.” from the report
- 01How are staffing levels monitored now, and how often do staffing shortages still affect activities outside the site?
- 02Have all paper support plans been transferred to the electronic system, and how is their accuracy checked?
- 03How are safeguarding concerns now shared with and reviewed by the local authority?
- 04How do you check that staff follow each person's positive behaviour support plan?
- 05What training and support do staff receive when managing challenging behaviour?
This was an unannounced comprehensive inspection covering all five CQC questions, with visits taking place over five days; the previous inspection was in January 2014. This explanation was written from the published report of 7 April 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Adult Pathways 2
2 rated inspections over 3 years: the service has held its Good rating throughout.
- December 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 4 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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