Background to this inspection
Updated
25 March 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
Two inspectors and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The Expert by Experience telephoned people’s families and had discussions about the quality of care.
Service and service type
The Paddocks is a ‘care home’. People in care homes receive accommodation and nursing and/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 a registered manager in post.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 5 December 2022 and ended on 22 December 2022. We visited the service on 5 December 2022 and 14 December 2022.
What we did before the inspection
We reviewed information we received about the service since the last inspection We asked for feedback and information about the service from the Local Authority and local Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke to 5 family members of people who lived in the home about their experiences of care and support. We spoke to 4 members of staff including care team leaders. We walked around the home and looked in people’s bedrooms, bathrooms, kitchens and communal areas. We took time to observe people in their homes and we reviewed medicines, care plans, staff recruitment files and incident management forms.
Updated
25 March 2023
About the service
The Paddocks is a residential care home providing accommodation and personal care to 5 people at the time of the inspection. The service can support up to 8 people.
People’s experience of using this service and what we found
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.
Right support:
The Paddocks was located in a rural area of Doncaster and people were able to access community facilities and had links with local villages and shops. The location enabled and supported people to access nature and countryside walks. The registered manager ensured there was a culture of person-centred care and 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 service supported this practice.
Right care:
Care was person-centred and promoted people's dignity, privacy and human rights. Education and learning were promoted. Medicines were not always managed safely and information was not always correct in medication sheets. Risk assessments were in place and detailed, however, plans were not always followed by staff. For example, where people were at risk of ingesting hazardous substances, cleaning products were not always locked away. Some parts of the service were not clean enough and presented a risk to infection prevention and control. The provider was in breach of regulations in relation to safe care and treatment. Following the inspection, the registered manager took immediate action to address the areas that needed improvement.
Right culture:
The ethos, values, attitudes and behaviours of leaders and care staff ensured people using services were leading confident, inclusive and empowered lives. There was a positive culture of person-centred care for people living at The Paddocks. People were engaged and involved in developing and improving their homes and the service. Families told us they are involved in care planning and reviews and said they were satisfied with communication and engagement from the service. Families felt that the staff promoted a safe, consistent and predictable atmosphere which met people's individual needs and told us the registered manager was approachable and good at listening. Compliance and quality monitoring systems needed to be further strengthened and embedded into practice. The outcomes of audits and checks and needed to be regularly reviewed to identify compliance, lessons learned and areas for improvement. The provider was in breach of regulations in relation to governance of the service. Following the inspection, the registered manager took immediate action to address the areas that needed improvement.
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 2 June 2021) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
At this inspection we found the provider remained in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 26 April 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the governance of the service.
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 remains requires improvement. 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
We have identified breaches in relation to medicines management, safe storage of cleaning products and governance of the service.
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.