The Paddocks

Updated 9 September 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 1 inspector and 1 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 care service.

Service and service type

The Paddocks is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement dependent on their registration with us. The Paddocks is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been appointed and was due to start in August 2023. We were supported by the area manager and deputy manager, who was a representative of the provider and was managing the service.

Notice of inspection

We gave a short period of notice of the inspection because some of the people using it could not consent to a home visit from an inspector. This meant that we had to arrange for a 'best interests' decision about this.

Inspection activity started on 26 July 2023 and ended on 31 July 2023. We visited the location on 26 July 2023.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We sought feedback from the local authority who work with the service. We reviewed the information we already held about the service. This included their registration report and notifications. A notification is information about important events, which the provider is required to tell us about by law. We used all of this information to plan our inspection.

During the inspection

We reviewed a range of records. This included 2 people's care records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including audits, incidents and accidents were reviewed. We reviewed 4 medicine administration records. We spoke with 6 members of staff including the area manager, deputy manager, 2 support workers and 2 agency staff. We were able to get limited views from people only due to their needs.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We continued to seek clarification from the provider to validate evidence found.

We looked at care records, staff training records and policies and procedures. After the inspection, we spoke with 6 relatives by telephone about their experience of the care provided.

Updated 9 September 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and 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 supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

The Paddocks is a care home registered to accommodate and support up to 8 people with learning disabilities, autistic people and people with mental health needs. At the time of the inspection, 7 people were living at the home. People living in the home had their own bedrooms and there were shared communal spaces, including lounges, a kitchen and a garden area, all on one floor.

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

The provider had made improvements following our previous inspection, to make the home safer. Improvements were needed to reporting processes to ensure that accidents and incidents were investigated appropriately. We looked at staff meeting minutes, there was no discussion about people's incidents and accidents or how to prevent any future incidents.

Following the inspection, the provider sent us evidence to indicate they had made changes to improve accident and incidents.

Right Support:

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 home supported this practice. The model of care at The Paddocks maximised people's choice, control and independence.

Staff were committed to supporting people in line with their preferences and supported people to receive their medicines safely and as prescribed. People were supported to access healthcare services to promote their wellbeing and help them to live healthy lives.

Staff managed risks to minimise restrictions, focusing on what people could do for themselves. The home had effective infection, prevention and control measures to keep people safe, including good arrangements for keeping the premises clean and hygienic.

Right Care:

Staff delivered care in line with information in people's care plans and recognised models of care for people with a learning disability or autistic people. This ensured people were receiving care tailored to them which promoted a good quality of life.

Staff had training on how to recognise and report abuse and they knew how to apply it. Staff recruitment, induction and training processes promoted safety, including those for agency staff. People were supported by staff who had received a wide range of relevant and good quality training to meet their needs.

Right Culture:

There was a positive culture at the home and people benefited from being supported by happy staff and this was reflected in the atmosphere at the home. Staff told us they enjoyed their job and making a positive difference to someone's life. Systems were in place to apologise to people, and those important to them, when things went wrong.

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 29 June 2022) and there were breaches of Regulation 13 (safeguarding service users from abuse and improper treatment) and Regulation 17 (good governance). The provider completed an action plan after the last inspection to show what they would do to improve. At this inspection we found improvements had been made and the provider was no longer in breach of these regulations.

Why we inspected

This was a planned inspection based on the previous rating and when the service was last inspected.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained the same. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Paddocks on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breach in relation to safe care and treatment at this inspection. We have also made a recommendation to follow best practice guidance around quality assurance.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.