The Paddocks Care Home

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 40 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did not always treat colleagues from other organisations with kindness and respect.

People told us they found the staff were kind and respected their privacy and dignity, especially during personal care. They acknowledged staff were busy but did not feel their care was rushed. We observed staff being very patient and caring for people in an individual way when time allowed. However, staffing levels contributed to a task focussed approach. The high number of new and agency staff also made it challenging for people to forge relationships with staff who were constantly changing. People who used the service commented on some staff speaking in their own language whilst providing care. They told us they found this to be unprofessional and disrespectful.

We noted some people who used the service accessing other people’s rooms whilst they slept. Staff told us this was routine behaviour for some and accepted the situation with little thought for people’s privacy and dignity. Some rooms overlooked the garden and the public carpark. Although the provider told us all people had access to curtains to maintain privacy, we noted several people were clearly able to be viewed from outside.

Several staff told us about a culture within the staff team which they felt was not always kind and supportive. The provider had been doing work to try and address this, and we saw evidence of some initiatives.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Care plans did not always contain a complete history of the person which made it difficult for staff, especially agency staff, to get to know them as a person. This was especially important for those people living with dementia. Care plans included some specific information about people’s care and support needs, and these were helped staff care for them safely and effectively. However, some risk assessments were quite generic and did not give staff enough guidance. For example, the risk assessments we viewed relating to the lift being out of order contained the same wording, rather than being individualized, and some had other people’s names recorded. Some information in risk assessments was contradictory leaving people at risk of not receiving the care they needed.

The provider did not promote people’s independence, so people did not know their rights and have choice and control over their own care, treatment and wellbeing.

People told us they did not have access to their care plan and did not always feel fully included in choices about their care. One person said,’ I don’t know anything about a care plan, and they don’t talk to me about it’. Staff did not always promote people’s independence or respect their choices over routine matters in their daily life. One person said, ‘I can go out in the garden but when I do, they always send someone with you. I don’t like that’ and two others commented on the lack of specific activities for men. There was no meaningful occupation or activity for those people living with dementia during our onsite assessment visits. However, people were asked what time they wanted to get up or go to bed and this was respected as much as staffing would allow, and overall feedback from people on the residential unit was mixed.

The provider did not listen to and understand people’s needs, views and wishes. Staff did not respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

We observed individual staff acting to ease people’s distress and discomfort, but many staff were new to the service and did not know people well or fully understand their needs. We also observed people clearly upset and distressed by the heat and one person taking their clothes off in the corridor and shouting about being hot. The response to this was not prompt and the staff and management were not proactive about how to manage people’s discomfort in the heat. We observed a lack of fans and some people with heavy blankets on, and windows shut at night, making them hotter. This was not always the person’s choice as we observed staff the following day asking people if they wanted fewer blankets and they agreed they did.

People’s pain was managed well in most cases, but some staff were not aware of how people living with dementia expressed their pain and risked hurting those who were resistant to personal care. One person’s shouting out was put down to their usual behaviour rather than trying to identify if there was any cause.

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

Although the provider had mechanisms in place for staff to share concerns either with their line manager or to the provider directly via their Talk2Us model. Multiple staff told us they felt unable to do this due to what they perceived as a punitive culture. Staff were reticent to explain in detail. One staff member told us they had raised an issue and an immediate change to their job role had been made. They viewed this as punitive. Another told us the response to their concern had not been timely. However, staff mostly worked well together and valued their colleagues individually, but they did not feel the provider truly had workforce wellbeing as a priority.