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Inspection carried out on 29 January 2021

During an inspection looking at part of the service

Service type

Paxton Hall Care Home is a residential care home providing accommodation and personal care to older people and people living with dementia in one adapted building. The service can support up to 39 people.

We found the following examples of good infection prevention and control (IPC) practice.

The service was only receiving essential visitors at the time of our inspection. Any person entering the building had their temperature taken, completed a health questionnaire, sanitised their hands and wore full personal protective equipment (PPE). We observed staff wearing PPE correctly, social distancing and good standards of infection prevention and control. Disposable crockery and cutlery were used to prevent the risk of infection spreading for any person admitted to the service.

The service had dedicated visiting facilities which had been paused at the time of our inspection. The registered manager had various ways relatives and friends could visit any person who was unwell or on end of life care. The number of visitors and length of visit was based on individual circumstances. Additional measures had been implemented for people including technology for virtual meetings with family members.

Staff supported people to be safe as they wore full PPE and adhered to good standards of IPC to mitigate the risk of cross contamination or spreading infections. Changes to the layout of equipment, furniture and the service helped keep people safer including promoting social distancing.

Staff had separate facilities for putting on and taking off PPE and COVID-19 testing.

Swift and effective action was taken if staff or people tested positive or if they had been in contact with a person who had tested positive. Individual risk assessments were in place for any person or staff member at an increased risk of infections.

Audits and governance were effective in ensuring the premises were clean, odour and clutter free. Learning about COVID-19 testing had been implemented and this increased safety for people and staff. The registered manager told us that they worked collaboratively with their local GP as a clinical lead with support from other health professionals.

Inspection carried out on 8 January 2020

During a routine inspection

About the service

Paxton Hall is a residential care home providing personal care to 28 people aged 65 and over at the time of the inspection.

Paxton Hall accommodates up to 39 people in one adapted building.

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

People who lived at Paxton Hall Care Home received care from a staff team who were all caring about delivering an individual based service. Staff knew each person well. People’s views were respected, and they were involved in everything that happened in the service. People were happy living there and relatives trusted the staff team to look after their family members. One relative said, “It’s wonderful here I couldn’t wish for anywhere better for [family member]”

Staff understood the risks to people and the measures in place to keep them safe. Systems were in place to manage people's medicines safely and to reduce the risks associated with the spread of infection.

Sufficient numbers of staff were employed to meet people's needs. Staff received training which gave them the necessary skills and knowledge to carry out their roles and meet people’s needs.

Staff delivered care and support that was personalised. Staff were kind, caring and motivated and people, their relatives and external professionals were complimentary about the care provided. Staff respected people’s privacy, dignity and independence and encouraged people to lead their life in the way they wanted to.

People were supported to maintain their health. Staff made referrals to health professionals when required. Staff were kind and caring and had developed good relationships with people using the service. People were supported to have maximum choice and control over 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.

People had access to food and drink based on their individual choice and preferences. People had access to a range of activities that reflected their specific needs and interests. There were plans to increase the activities offered especially for those living with dementia.

Care plans were in place which guided staff to provide support that met people's needs which were in line with their preferences.

Systems ensured that people's risks were well managed, and lessons were learnt when things went wrong. There was an open culture within the service, where people and staff could approach the registered manager who acted on concerns raised to make improvements to people's care. A relative told us, “I can’t fault this home. I can’t think of anything that would improve it. The staff are great and keep me well informed.”

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 11 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Inspection carried out on 27 June 2017

During a routine inspection

Paxton Hall is a care home providing accommodation for up to 39 older people, some of whom live with dementia. It is not registered to provide nursing care. 26 people were living at the service on the day of our inspection.

This unannounced inspection took place on 27 June 2017. At the last inspection on 16 January 2015 the service was rated as ‘Good’. At this inspection we found overall the service remained ‘Good’.

A registered manager was in post at the time of the inspection. 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 2008 and associated Regulations about how the service is run.

Systems were in place to manage risks to people using the service and to keep them safe. This included assisting people safely with their mobility and with their medicines.

Staff had received training to safely assist and support people. The recruitment and selection procedure ensured that only suitable staff were recruited to work with people using the service. There were enough staff employed to ensure people that peoples needs were met.

The registered manager and staff understood the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People were supported to have choice and control over their lives as much as possible.

The management and care staff were knowledgeable about the people they supported and knew their care needs well. Staff offered people choices such as to how they spent their day and the meals they wished to eat. These choices were respected and actioned by staff.

People’s needs were assessed, so that their care was planned and delivered in a consistent way. There was a variety of activities and interests available for people to take part in so they did not become socially isolated.

People received the support required to maintain a healthy diet and were able to choose meals they preferred. People had access to a range of health care professionals, when they needed them.

People were clear about raising any concerns they had and were confident they would be responded to.

Staff understood the values of the service in relation to providing people with care that was dignified and in a respectful manner. We observed staff supporting people in a respectful and dignified manner during our inspection.

The provider had processes in place to assess, monitor and improve the service. People had been consulted about how they wished their care to be delivered and their choices had been respected. People, their relatives and staff were provided with the opportunity to give their feedback about the quality of the service provided.

Further information is in the detailed findings below.

Inspection carried out on 2 December 2014

During a routine inspection

Paxton Hall is a residential home, providing accommodation and personal care for up to 39 older people. There were 25 people living at the home at the time of our inspection.

This unannounced inspection took place on 02 December 2014. At our previous inspection on 30 April 2013 we found the provider to be meeting all the regulations that we looked at.

At the time of our inspection the home did not have a registered manager. The registered manager left the service in July 2014. 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 and associated Regulations about how the service is run.’

During this inspection we found that staff treated people in a way they liked and there were sufficient numbers of staff to safely meet people’s needs. People received good quality care which had maintained their health and well-being. Staff kept family members well informed of events that affected their relative and people in the home, and their relatives were very happy with the care provided

People lived in a safe and well maintained environment. Medicines were stored correctly and records showed that people had received them as prescribed. Staff had received appropriate training for their role.

Staff supported each person according to their needs. This included people at risk of malnutrition or dehydration who were being supported to have sufficient quantities to eat and drink.

We saw that staff respected people’s privacy and dignity. They knocked on people’s bedroom doors and waited for a response before entering. People told us that staff ensured doors were shut when they were assisting them with their personal care.

People’s needs were clearly recorded in their plans of care so that staff had the information they needed to provide care in a consistent way. Care plans were regularly reviewed to ensure they accurately reflected people’s current needs.

People confirmed they were offered a variety of hobbies and interests to take part in and people were able to change their minds if they did not wish to take part in these

Effective quality assurance systems were in place to monitor the service and people’s views were sought and used to improve it. The interim managers were bringing about change to support staff to ensure that people were receiving a good quality of care and support.

Inspection carried out on 30 April 2013

During a routine inspection

During our inspection on 16 October 2012, we had concerns that staff were not adequately supported as there was no formal system in place to appraise and supervise staff. The provider sent us an action plan that provided us details of when they would be compliant. During this inspection on 30 April 2013, we found that appropriate formal systems had been put in place.

We found that people�s care records gave staff the information they required to provide individual care and support. Risks had been identified and minimised.

Medication administration, storage and recording were in good order and people were not put at risk of being given incorrect medicines.

People we spoke with were complimentary about the food they were provided, and told us they were able to make choices.

There was a complaints procedure in place and people we spoke with told us they had no complaints. The home had dealt with complaints appropriately and they were in the process of investigating a recent complaint from a family.

Inspection carried out on 16 October 2012

During a routine inspection

During our inspection on 16 October 2012, we spoke with six people who lived in the home. They all said that they were involved in the planning of their care. They also told us they were asked their views about the care provided at their regular �residents meetings� and through a questionnaire. One person told us, "It�s a wonderful place. We are well looked after". They all told us they felt safe and would raise any concerns with the manager.

We observed staff supporting people in a kind and calm manner. We observed that staff spoke respectfully with people. Staff had been provided with appropriate training to enable them to meet the needs of the people who lived in the home.

The organisation had systems in place to monitor the quality of the service provided and action was taken to address any issues that were highlighted as needing improvement.

We found that the provider had not ensured that all staff had been formally supervised and appraised.

Inspection carried out on 5 October 2011

During an inspection looking at part of the service

People with whom we spoke were unable to tell us their views about how the home supports them, however, we saw that staff were interacting with people who use the service in an appropriate way when supporting them with their care needs. We also found that staff were aware of people's individual care and support needs and how these were to be met.

Inspection carried out on 14 June 2011

During a routine inspection

We received positive comments from people with whom we spoke. They told us they were satisfied with their care and they had confidence in the capability of the staff. Visitors to the home described the standard of care as �excellent� and �very good�. No one had any concerns or complaints about the care or about the home.

People felt safe living at the home and they felt actively listened to. Their views about the home were sought, in areas such as the standard of food, cleanliness of the home and the provision of social activities, and they advised us that they were satisfied with the action taken to improve any areas that they had identified.

Reports under our old system of regulation (including those from before CQC was created)