Little Paddocks

Little Paddocks is a residential care home providing accommodation and personal care for up to eight autistic people and people with a learning disability. At the time of the inspection eight people were living in the service.

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

The provider had processes in place to check staff were safely recruited; however, these processes were not always effective.

We have made a recommendation about the provider’s recruitment processes.

Relatives did not always feel involved in planning and reviewing people’s care or kept up to date about changes in the service. Relatives did not always feel their concerns had been responded to promptly by the provider.

The service had undergone several changes in management structure since the last inspection and a new registered manager had only recently come into post. People, relatives and staff spoke enthusiastically about the changes the registered manager had introduced and the positive impact this was starting to have on the service.

People told us they felt safe. Risks to people’s safety were assessed and staff knew how to report any concerns. There were enough staff available to meet people’s needs and staff received an induction and training relevant to their role. Staff told us they felt supported and valued.

Staff followed safe infection prevention and control processes and guidance was available to support staff during the COVID-19 pandemic. People received their medicines as prescribed and staff had received medicines training.

People told us the staff were kind and caring. 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.

The provider had systems in place to monitor the quality and safety of the service and worked effectively alongside other health professionals to meet people’s needs. People and relatives spoke positively about the culture and management of the service.

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 statutory guidance which supports CQC 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.

The size of the service was in line with current best practice guidance and the homes were personalised to reflect people’s individual preferences. People were involved in making decisions about their home and told us they were happy living with their housemates. People were supported to make decisions about their daily care and staff understood people’s personal preferences and support needs. Staff promoted people’s independence and were respectful of their privacy and dignity. People were supported to find employment opportunities and to take part in activities within the local community. The new registered manager and staff team were working to make improvements to ensure people and relatives were fully involved in planning their care and to ensure people were supported to achieve good outcomes.

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

Rating at last inspection

The last rating for this service was Good (published 6 June 2018).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

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.

Little Paddocks (which is run by Maison care) provides accommodation and personal care for up to eight people who have a learning disability and/or autistic spectrum disorder. Little Paddocks is a purpose built twin set of bungalows which accommodate four people in each. The service is situated in a residential area of Little Clacton and is close to amenities and Clacton on Sea. The premises is set out on one floor with each person using the service having their own individual bedroom and adequate communal facilities are available for people to make use of within the service. At the time of our inspection seven people were using the service.

At our last inspection of this service on 28 October 2016 the service was rated Good. At this inspection we found the service remained Good.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

There were safeguarding and whistle blowing procedures in place and staff had a clear understanding of these procedures. We observed this throughout our inspection and people, relatives and staff told us there was always enough staff on duty to meet people's needs.

Appropriate recruitment checks were carried out before staff started working at the service. People were receiving their medicines as prescribed by health care professionals.

Staff had the knowledge and skills required to meet people's needs. Action was taken to assess risks to people’s safety and wellbeing. People's needs were assessed and care plans included detailed information and guidance for staff about how their needs should be met. People were encouraged to eat healthy meals and to cook for themselves where able.

The registered manager and staff had a good understanding of the Mental Capacity Act 2005 and acted according to this legislation. Staff monitored people's mental and physical health and where there were concerns people were referred to appropriate health professionals and services.

People's care records included communication profiles that recorded their specific methods of communication with staff. It was evident that staff knew people well and communicated with them effectively. People were supported to engage in friendships, access the community, attend clubs and places of work and enjoy aspects of their cultural backgrounds where required. Care records were person centred and included people's views about how they wished to be supported. The service had a complaints procedure in place and this was available in a format that people could understand.

The registered provider recognised the importance of regularly monitoring the quality of the service they provided to people. The registered manager and staff worked effectively with other organisations to ensure staff followed best practice. They took into account the views of people and their relatives through surveys, meetings and one to one communication. Staff said they enjoyed working at the service and they received good support from the registered manager. The registered manager was a visible presence in the service each day and was readily available on both days of our inspection.

There was a registered manager 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 and their visitors were complementary about the relaxed atmosphere of the service and welcoming, friendly staff.

Staff knew people well and had developed good relations with people and their relatives. Staff respected people’s privacy and dignity at all times and interacted with people in a caring, respectful and professional manner. There were sufficient numbers of staff, who were trained and supported to meet the needs of the people who used the service.

People and their relatives felt that the service was providing safe care. Risks to people were assessed and appropriate measures taken to minimise risk, without unnecessarily restricting people’s independence. Where restrictive practices were in place to ensure people’s safety, the service was aware of the changes to the law regarding the Deprivation of Liberty Safeguards (DoLS). Where needed, appropriate referrals were made to external professionals.

People, and where appropriate their representatives, were involved in making decisions about their care and support. People’s care plans had been tailored to the individual and contained information to support their physical and mental health needs and their ability to make decisions. People were supported to access a range of educational, work and leisure activities, linked to their personal choice and preferences.

Dietary needs and nutrition were well managed and advice sought from appropriate health professionals as needed. Good working relationships had been developed with external health care professionals. There were appropriate arrangements in place to safely support people with their prescribed medicines. We have made a recommendation to ensure medicines, were stored at the correct temperature.

People their relatives and staff could voice their views and opinions. A complaints procedure was in place and people were asked their views of the service to drive on-going improvements. Staff understood their roles and responsibilities in providing safe and good quality care to the people who used the service. They were committed to using continuous feedback from people as part of their quality assurance system for continued improvement.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

When we arrived at the service we were greeted by the senior member of staff on duty and the acting manager. We were asked for our identification and asked us to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

People told us they felt safe living in the service and that they would speak with the staff if they had concerns.

We saw evidence of the way the service had responded to concerns about the safety and wellbeing of people who used the service. The provider had responded in a way that kept people safe and ensured appropriate investigations took place in response to concerns.

People told us that the staff were available when they needed them to help and support them. One person told us about how they were supported to manage their finances. They were happy that the support offered was helpful but not intrusive.

Is the service effective?

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The care plans were indexed for ease of reading and finding information. The records had recently been reviewed and updated as required. This meant that staff provided information that was up to date about how people's needs were met.

Is the service caring?

We saw that the staff interacted with people who used the service in a caring, respectful and professional manner. One person showed to us the garden where they were growing vegetables. They told us. 'The staff have shown me how to do this.' There were arrangements in place for the staff to work with other organisations to support people to follow their life-style choices and provide care.

Is the service responsive?

The service arranged and supported people to go shopping to purchase the food they liked to eat. People who used the service were provided with the opportunity to participate in activities which interested them. People's choices were taken into account and listened to as each person had an individualised program of activities to pursue.

One person told us that they knew how to make a complaint if they were unhappy. We saw that the service had involved advocates appropriately to support people and had arranged for people who used the service to learn skills to help them communicate with people.

People's care records showed that where concerns about their wellbeing had been identified, the staff had taken appropriate action to ensure that people were provided with the support they needed.

Is the service well-led?

The acting manager had developed a training program for staff designed to develop their skills to provide care to the people who used the service. There was a quality assurance system in place which included a complaints policy and procedure and robust recruitment arrangements.

It was evident that staff knew people well and we saw that there were good interactions between members of staff and people who lived in the home; staff listened to people and treated them with respect.

We noted that the environment in Little Paddocks was spacious, with sufficient communal areas to meet the needs of people who lived there. We saw that people were comfortable in their surroundings.

We found that staff received the training and support they needed to provide care and support safely. They were able to demonstrate that they understood the specific needs of the people who used the service and provided care in a person-centred manner.