Archived: The Paddocks

The care service has 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. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At the last inspection in April 2016 the service was rated Good. At this inspection we found the service remained Good.

The service had a registered manager. 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.

We last inspected this service on 7 April 2016. During that inspection we found the service did not update people's care plans. At this inspection we found improvements had been made and the service had updated people's care plans. This meant that people had care plans that reflected their current needs.

We found care plans were personalised and risk assessments, which identified potential risks to people and guidance for staff on how to manage them, were completed and reviewed. This ensured that risks to people were minimised.

During this inspection, we found the registered manager’s arrangements for staff supervision and appraisal, and the management of people's personal allowances were not effective. We noted that the registered manager listened to people, relatives and staff; sought feedback, and was ready to work with all the stakeholders.

The service's staff recruitment was robust to ensure that new staff were appropriately checked and inducted before starting to work with people. There were enough number of staff, who received training in adult safeguarding and were able to support people. Training included adult safeguarding and Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Deprivation of Liberty Safeguards is where a person can be deprived of their liberties where it is deemed to be in their best interests or for their own safety.

People were encouraged and supported to live as independently as possible. Their care plans were personalised, and people could choose what and when to eat and drink. Staff ensured people's preferences of diet, whether it was because of health or culture, were respected.

The service sought and included people's views for further improvement of the service. We noted the service listened to and addressed people's concerns and complaints.

The service met people's health needs. Medical check-ups and appointments with health professionals were made and people were supported to attend them to ensure they had appropriate treatments. Medicines were safely recorded, stored and administered to ensure people received them as prescribed.

The service has a registered manager. 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.

We last inspected this service on 14 and 16 January 2015. During that inspection we found that the provider was in breach of the regulations that related to safe care and treatment, person-centred care, safeguarding and staffing. People were not protected as staff did not have sufficient knowledge to identify the possibility of abuse and prevent it from happening. Additionally staff had not received appropriate training to enable them to deliver care to an appropriate standard. People were not protected from the risk of receiving unsafe or inappropriate care and were not receiving a person centred service. The provider sent us an action plan stating the steps they would take to address the issues identified. At this inspection we found that improvements had been made and the regulations were now being met.

People were safe at the service. Staff had a good understanding of safeguarding and how to recognise and prevent abuse from happening. Staffing levels were sufficient to support people safely.

Staff received the training and support they needed to provide a safe service. This included training to support them to meet people’s complex needs.

The staff team worked with other professionals to ensure that people were supported to receive the healthcare that they needed.

People chose what they wanted to eat and drink. Staff supported them to have a healthy diet and to eat and drink enough to meet their nutritional needs.

People were protected by the provider’s recruitment process which ensured that staff were suitable to work with people who need support.

Staff supported people to make choices about their care. Systems were in place to ensure that their human rights were protected and that they were not unlawfully deprived of their liberty. Staff had received Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) training. Deprivation of Liberty Safeguards is where a person can be deprived of their liberties where it is deemed to be in their best interests or for their own safety. Staff were aware that on occasions this was necessary. We saw that when this was necessary to keep people safe, the proper process had been followed to obtain agreement from the supervisory body.

People were encouraged and supported to maintain their independence and develop their skills. They took part in activities both in the service and in the community.

Staff and relatives told us that there had been a lot of improvements in the service since the registered manager came into post.

Although people's care plans were personalised and comprehensive they were not always up to date. We have recommended that all care and support files be streamlined, reviewed and updated to ensure that staff have current information and guidance to work to.

People lived in an environment that was suitable for their needs. Some decorative improvements had been made and further renovation was planned.

The registered manager and the provider monitored the quality of service provided to ensure that people received a safe and effective service that met their needs.

We found that the service had taken steps to protect people from abuse. Care staff had received training about safeguarding vulnerable adults and systems were in place to reduce the risk of financial abuse occurring. The service had a complaints system in place. A relative told us "I think they would listen to me if I made a complaint." We found that medications in the home were stored securely and accurate medication records were maintained. The service had robust staff recruitment and selection procedures in place.

People were supported to eat adequate amounts of food, and were able to choose what they ate. We found people had their own bedrooms, and that steps had been taken to ensure the physical environment was safe and accessible. There were enough staff working at the service to meet people's needs.