Blackburn Road

Updated 30 May 2018

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 30 April 2018 and was unannounced. The inspection was carried out by one adult social care inspector.

Before our inspection we reviewed the information we held about the service including notifications the provider had sent to us; these are events which happen in the home that the provider is required to tell us about. We also contacted Healthwatch, the local authority’s infection control and contract monitoring teams as well as a number of community based professionals for feedback about the home.

During the inspection we spoke with three people who used the service, two members of staff, the manager, the deputy manager, the business development manager and one of the directors of the service.

We looked at the care and medicines records for three people who used the service and the personnel files for three staff members. We also looked at a range of records relating to how the service was managed; these included staff training records, quality assurance systems and policies and procedures.

Updated 30 May 2018

We carried out an unannounced comprehensive inspection on 30 April 2018.

Pathways (North West) Limited – Blackburn Road is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual

agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Pathways (North West) Limited – Blackburn Road is registered to provide accommodation and personal care for up to seven people with a mental health diagnosis. There were seven people living in the service on the day of our inspection. Staff employed to support people were referred to as life skills trainers which reflected the rehabilitation focus of the service.

The home did not have a registered manager in place. 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. A new manager had been appointed since the last inspection. They were in the process of applying to CQC to register as manager of the home.

At our last comprehensive inspection on 5 April 2017, we found the provider was not meeting two of the regulations we reviewed. We therefore asked the provider to take action in relation to the recruitment of staff and the systems in place to monitor the quality and safety of the service.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions ‘Safe’ and ‘Well-led’ to at least good. During this inspection we found recruitment processes had been improved, although one aspect of the process needed further action. This was because reasons for gaps in applicants’ employment history had not been properly investigated and documented by the staff at head office who were responsible for the recruitment process. We found systems in place to monitor the quality and safety of the service were now sufficiently robust.

People told us they felt safe in the home and staff were kind, caring and respectful towards them. Staff had completed safeguarding training and were able to tell us the correct action to take should they witness or suspect abuse. People told us there were always sufficient numbers of staff on duty to support them with activities or daily living tasks.

Robust systems were in place for the safe handling of medicines. Staff had received training in how to administer medicines safely. Their competence for this task was assessed when they started work at the home. The manager confirmed they would ensure these competence assessments were completed on an annual basis.

Care records we reviewed included detailed information about the risks people might experience. Care plans were in place to help ensure staff provided the level of support necessary to manage the identified risks. Care plans were regularly reviewed to address any changes in a person’s needs.

Systems were in place to help ensure the safety and cleanliness of the environment. People who used the service were encouraged to participate in cleaning the home.

Staff told us they received the induction, training and support necessary for them to be effective in their role. The provider had recently introduced a new training system which staff told us was good quality and appropriate to help them meet the needs of people who lived in the home.

Staff had a good understanding of the Mental Capacity Act (MCA) 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were encouraged to have a healthy diet, although staff recognised people were able to make their own choices about the food they ate. The manager had introduced improved systems to monitor the physical health of people who lived in the home.

Staff demonstrated a commitment to providing high quality person-centred care which met the diverse needs of people who lived in the home. Care records we looked at showed people who used the service had been involved in reviewing their care and support plans. The provider had recently introduced a system of electronic care records. Staff had provided positive feedback on this initiative as they considered it allowed them to spend more time with people who lived in the home.

The nationally recognised ‘Recovery Star’ was used to help people recognise the goals they had achieved. People who used the service were encouraged to participate in activities which met their interests and helped to promote their health and well-being. People told us staff would always encourage them to be as independent as possible.

All the people we spoke with told us they felt able to raise any concerns with their keyworker or the manager and were confident they would be listened to. We noted systems were in place to encourage people who used the service to provide feedback on the care and support they received.

Staff we spoke with told us they enjoyed working in the service and felt valued by both colleagues and the manager. Staff felt able to raise any issues of concern or make suggestions to improve the service in supervision and staff meetings.

The manager had a good understanding of the needs of people who lived in the home. They told us they operated an ‘open door’ policy for people who used the service and staff. They demonstrated a commitment to on-going service improvement.