The Paddocks

At our last inspection we rated the service Good overall and in each of the five questions that we ask. At this inspection we found the evidence continued to support the overall rating of Good. There was no other evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. However further improvements were needed within the key question of Effective. Staff did not all have the necessary up to date training to ensure people received effective care from staff who were suitably trained. Improvements were needed to ensure compliance with the Mental Capacity Act. For one person, continuous supervision and control, combined with lack of freedom to leave, indicated a deprivation of liberty, and the provider had not applied for this to be authorised under Deprivation of Liberty Safeguards.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The care service had not originally been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. However, despite not being developed in line with these values, people’s participation within the local community was encouraged and enabled.

The Paddocks is a service owned and operated by Mr Gibbs who is the provider of the service and also the registered manager. The people using the service are either the adopted siblings of the provider or they were looked after as children and have grown up with him at the home since they were children when the service was run by their parents. The registered manager is referred to as the provider throughout our report.

Improvements were needed to the providers oversight of the service. The fire risk assessment in place was insufficient had had not identified fire safety arrangements at the service were not safe. The providers systems had also failed to identify that some staff training was out of date.

The service is a large family home and the provider and his wife also live on site in a separate flat. In addition, a small group of staff are employed by the service. People and the provider referred to one another as ‘family’ and ‘brothers and sisters’ and as is common place with some families, were very familiar with one another and openly discussed one another’s circumstances. People we spoke with told us they felt safe living at the service. Medicines procedures were in place for staff to follow and medicines were ordered, stored and administered safely.

There were sufficient staff employed to meet people's needs; keep them safe and provide them with person centred support. Appropriate recruitment procedures were in place to ensure only suitable staff were employed. Staff were aware of their roles and responsibilities and told us they were well supported.

The service had a complaints procedure. People were happy living at the service and had made no complaints.

The inspection was unannounced and took place on the 25 May 2016.

The home is not required to have a registered manager in place because the provider is in control of the day to day running of the home.

The Paddocks is a service owned and operated by Mr Gibbs. The people using the service are the adopted siblings of the provider, and have grown up with him at the home since they were children when the service was run by their parents. As a result, the provider had an in depth knowledge of the needs of these people and their personalities. This was evident when speaking with the provider and when observing their interaction with people using the service.

The service is orientated around traditional family life, and there was an open and inclusive atmosphere. People spoke fondly of each other, the provider and the provider’s wife. A small group of staff were employed by the service, and people said positive things about how they helped them. We observed positive interactions between staff and people, and saw that staff encouraged them to be as independent as possible.

People told us they felt safe living at The Paddocks and that the staff and provider helped them to feel safe and secure in their home. There were systems in place to identify and reduce the risks to people and protect them from harm. Staff and the provider were proactive in reducing risks to people and protecting them from harm.

The service had in place robust recruitment procedures which ensured that staff had the appropriate skills, background and qualifications for the role. There were enough suitably trained staff available to support people during our inspection.

There were effective systems in place to ensure that medicines were stored, managed and administered safely. People received appropriate support to take their medicines.

Staff told us they felt supported by the management of the service and that the training they received provided them with a good understanding of topics such as the Deprivation of Liberty Safeguards (DoLS). People and their relatives spoke highly of the staff.

The service was complying with the requirements of the Mental Capacity Act (2005) and the DoLS. Appropriate consideration had been given to whether DoLS applications were required for anyone using the service. People were supported to make decisions independently and were encouraged to develop independent living skills.

People were encouraged and supported to take part in many activities they enjoyed, within the service and in the community.

People told us and we observed that the staff and provider were caring and kind towards them.

There were systems in place to monitor the quality of the service and to identify shortfalls or areas for improvement. There was an open culture at the service. People using the service, their advocates and staff were given the opportunity to express their views and these were acted on by the service. There was a complaints procedure in place and people told us they knew how to make a complaint if they weren’t happy.

People told us that the staff treated them with respect and kindness. One person said, 'They (staff) are caring and nice. We go out and do things I like to do.'

During our inspection we saw that staff interacted with people in a caring, respectful and professional manner.

We looked at three people's care records and found that they experienced care, treatment and support that met their needs and protected their rights. Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

The care records showed that people's needs were assessed and care and treatment was planned in line with their individual care plan. We saw evidence in the care records that people received safe and coordinated care, treatment and support where more than one provider was involved.

We looked at staff records and spoke with two members of staff who told us they were being appropriately trained and supervised. We saw that the service provided enough qualified, skilled and experienced staff to meet people's needs.

We looked at the way that complaints were recorded and dealt with, and saw that people's feedback was acted on and handled in line with the provider's policy.

People had a choice of a range of daytime and evening work and leisure activities, which included working in local shops and on the smallholding attached to the service. The four people we spoke with all told us that they enjoyed the work that they did.

We looked at care records which contained detailed care plans and risk assessments. These showed how the person they related to been involved, and had discussed their own care with staff. People told us they felt safe and procedures were in place to ensure that any allegations of abuse were properly investigated.