Pathway House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates up to 12 people in one adapted building. The home can be divided into two separate units, each for six people, when the needs of the people being accommodated require it.

We spoke with the registered manager about the CQC’s document ‘Registering the Right Support’, which asks care homes providing support to people with learning disabilities, to work within certain guidelines. We confirmed with the registered manager that they were aware of this document. They had considered whether they needed to make any changes and felt they were already working within the principles of this model of support.

At our previous inspection in November 2015 we rated the service as good in all five of the questions we ask. The first inspection visit to the service took place on 22 November 2017 and was unannounced. We arranged to return for a second visit on 5 December 2017.

This service requires a registered manager as a condition of its registration. 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. There was a registered manager in post who had been managing the service since it opened in July 2014.

During our first visit we found that medicines were not always being managed safely. The registered manager carried out a thorough and objective investigation into all aspects of medicines management. The actions they took meant that by our second visit people were receiving their medicines safely and as they had been prescribed.

People felt safe living at the service, with the staff and with the support the staff gave them. People were protected as far as possible from abuse and avoidable harm by staff who were trained and competent to recognise and report abuse. Assessments of all potential risks to people and to staff were carried out and measures put in place to minimise the risks, without limiting the freedom that people wanted to take risks appropriately.

There was a sufficient number of staff with the right experience, skills and knowledge deployed to make sure that people were kept as safe as possible. There was an effective recruitment process in place to reduce the risk of unsuitable staff being employed. Staff were clear about their responsibility to report accidents, incidents and concerns and they followed the correct procedures to prevent the spread of infection.

Holistic assessments of people’s support needs were carried out before the person was offered a place at Pathway House, to ensure that the service could provide that support in the way the person preferred. Technology, such as a mobile phone for use when people went out unescorted, was used to enhance the support being provided.

Staff received induction, training and support to enable them to do their job well. When required, staff supported people to cook a meal or to contact external healthcare professionals such as GPs. The service had been effective in supporting a number of people to achieve what they wanted to achieve and move on to more independent living.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People and their relatives praised the staff, had good relationships with them and described them as caring, supportive and professional. Staff made people feel they mattered and knew each person, and the details about the support the person needed, very well.

People were invol

This inspection took place on 24 November 2015 and was unannounced.

The inspection was carried out by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.

Pathway House is a residential care home on the site of Milton Park Therapeutic Campus. Pathway House provides a hospital step down service which enables residents to transition out of a mental health hospital placement into the community when a transition to a ‘typical’ residential care home would be too great. Pathway House is registered to provide accommodation with personal care for up to12 people. It is part of Brookdale Healthcare Limited. On the day of our inspection ten people were using the service.

There was a registered manger in post. 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.

People felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and how to report them.

People had risk assessments in place to enable them to be as independent as they could be.

There were sufficient staff, with the correct skill mix, on duty to support people with their needs.

Effective recruitment processes were in place and followed by the service.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service.

Staff received a comprehensive induction process and ongoing training. They were well supported by the registered manager and the unit manager and had regular one to one time for supervisions.

Staff had attended a variety of training to ensure they were able to provide care based on current practice when supporting people.

Staff gained consent before supporting people.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people.

People were able to make choices about the food and drink they had, and staff gave support when required.

People were supported to access a variety of health professional when required, including dentist, opticians and doctors.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well.

People and relatives where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times.

People were supported to follow their interests.

A complaints procedure was in place and accessible to all. People knew how to complain.

Effective quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.