Archived: Paddock Hill

We found the following examples of good practice.

The premises were clean, hygienic and well ventilated. Additional cleaning schedules had been introduced since the beginning of the coronavirus pandemic. For example, door handles and light switches were regularly cleaned throughout the day. Regular audits were carried out to make sure good IPC standards were being maintained.

The service was accessing the government testing scheme which had assisted them to identify an outbreak quickly. The service was working with the local authority IPC team and other health professionals in managing the outbreak. In order to prevent the potential spread of infection around the home, staff movement was limited as much as possible and each staff member were assigned a unit to provide care and support to people.

Further information is in the detailed findings below.

Paddock Hill is a residential care home that provides accommodation and personal care for adults with a range of care and support needs, including adults who are living with dementia. The home can accommodate up to 40 people in one adapted building over three floors. At the time of this inspection there were 38 people using the service.

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

People felt safe living at Paddock Hill. They were cared for by staff who knew how to reduce the risk of people experiencing avoidable harm. Staff were aware of their responsibilities to safeguard people from abuse and they were all confident the registered manager would quickly address any concerns they raised. People’s medicines were mostly managed safely, however, some improvements were needed to the management of people’s topical medicines, such as creams, and medicines people needed at specific times of the day. People were protected from the spread of infection.

There were enough staff available to keep people safe, however, staff said they did not always have time to support people to remain meaningfully occupied throughout the day. We have made a recommendation about the development of activity provision in the home. People were cared for by staff who knew them very well. People’s care records contained detailed information about their preferences and interests. This supported staff to provide personalised care to people. People were happy with the care they received from staff. People and their relatives told us they could raise any concerns with the staff or registered manager.

Everyone told us the staff were kind and caring. We observed staff had a good rapport with people living at Paddock Hill. Staff provided effective reassurance to people when they became anxious or distressed. People were supported to remain involved in decisions about their care. Staff promoted people’s privacy and dignity and they treated people with respect. People told us staff supported them to remain as independent as possible.

People enjoyed the food at Paddock Hill. Staff supported people to maintain a nutritious diet. People were supported to maintain their heath, by accessing community health professionals on a regular basis. People were supported by staff who completed regular training and received effective support from the registered manager. People’s relatives told us they were happy with the quality of care their family member received. 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 home was well-run. People were supported by staff who enjoyed their jobs. An experienced registered manager completed a range of regular checks on the quality and safety of the service. Areas for improvement were identified, however increased management oversight of some areas of the service was required, to ensure necessary improvements were embedded and sustained. The provider, registered manager and staff were all committed to providing people with good quality care.

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

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 29 January 2019) and we identified one breach of regulation at that inspection.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of any regulations.

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.

People’s experience of using this service:

• The service met the characteristics of good in the key questions of effective, caring and responsive. However, some aspects of the service required improvement to ensure people remained safe. We found staff were not always deployed effectively throughout the home. For short periods of time staff were not available to support people in communal areas. Improvements were also required to the assessment and recording of risks to people, to ensure all appropriate steps were taken to reduce identified risks;

• People received personalised support from staff who knew them well. Staff had built positive relationships with people living at Paddock Hill. Staff supported people to retain their independence and to remain involved in planning and reviewing their care. This helped to ensure care was provided in accordance with people’s preferences;

• Staff worked closely with a range of community health professionals to promote good outcomes for people;

• Staff were kind and caring. They treated people with dignity and respect. People we spoke with told us staff treated them well and they liked living at Paddock Hill;

• People living at Paddock Hill, their relatives and staff could approach the management team if they had any concerns;

• Staff received regular training and had developed the right skills to enable them to provide effective care to people;

• More information is in the full report.

Rating at last inspection:

Good (report published on 7 June 2016)

Why we inspected:

This was a planned inspection based on the rating awarded at the last inspection.

Enforcement:

We found one breach of the Care Quality Commission (Registration) Regulations 2009. Details can be found in the key question of well-led. You can see what action we told the provider to take at the end of this report.

Follow up:

We will continue to monitor this service. We will check improvements have been made by completing a further inspection in line with our re-inspection schedule for those services rated requires improvement.

It is a condition of registration with the Care Quality Commission that the service has a registered manager in place. 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. There was a manager at the service who was registered with CQC.

At the last inspection on 24 March 2015, we asked the provider to take action to make improvements in regard to safe care and treatment, fit and proper persons employed and good governance and this action has been completed.

This inspection took place on 10 May 2016 and was unannounced. This meant the people who lived at Paddock Hill and the staff who worked there did not know we were coming. On the day of our inspection there were 40 people living at Paddock Hill.

People told us they felt well cared for and safe. Comments included, “We are all safe here” and “I’m not troubled at all. I am safe and well looked after.”

A healthcare professional spoken with told us they were visiting the home for the first time and had positive first impressions of the home.

We found systems had improved and were in place to make sure people received their medicines safely and medicines administration records were completed in line with safe procedures.

We found improvements to staff recruitment records which showed procedures were thorough and ensured people’s safety was promoted.

Staff were provided with relevant induction and training to make sure they had the right skills and knowledge for their role. They told us they worked well as a team and were well supported by the registered manager. All of the staff spoken with said they would recommend the home and be happy for a relative to live at Paddock Hill.

The service followed the requirements of the Mental Capacity Act 2005 (MCA) Code of practice and Deprivation of Liberty Safeguards (DoLS). This helped to protect the rights of people who may not be able to make important decisions themselves.

People had access to a range of health care professionals to help maintain their health. A varied and nutritious diet was provided to people that took into account dietary needs and preferences so their health was promoted and choices could be respected.

People living at the home said they could speak with staff if they had any worries or concerns and they would be listened to.

We saw people participated in a range of daily activities both in and outside of the home which were meaningful and promoted independence.

There were effective systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to. People using the service and their relatives had been asked their opinion via questionnaires, the results of these had been audited to identify any areas for improvement.

People living at Paddock Hill told us that they were happy and that they were satisfied with the care they received. They told us, "It is all right, good" and "The staff are smashing and very kind.'

Relatives spoken with said that they were happy with the care their loved one received. They told us, 'The staff know [my relative] well' and "We have no worries at all. I think this is a really good home."

During the inspection we were able to observe people's experiences of living in the home. We found that support was offered appropriately to people.

We found that before people received any care or treatment they were asked for their consent and the staff acted in accordance with their wishes.

We found that people's care and welfare needs were assessed and each person had a written plan of care that set out their identified needs and the actions required of staff to meet these.

We found that medicines were being obtained, recorded, handled, dispensed and disposed of in a safe way.

The provider had a satisfactory recruitment and selection procedure in place to ensure that staff were appropriately employed.

The provider had an effective complaints system available.