29 and 30 January 2015
During a routine inspection
We inspected this service on 29 and 30 January 2015. This was an unannounced inspection. Paddock House is a care home providing residential care for up to 30 older people, and also provides a rehabilitation service. There were 30 people using the service when we inspected. Our last inspection of this service was carried out on 21 May 2013. There were no breaches in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 identified at the inspection.
There was a registered manager in post. 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.
Systems were in place which guided staff on how to manage risks, medicines and safeguard the people who used the service. Staff could recognise signs of harm or potential abuse and knew who to report concerns to. Procedures were in place which guided staff on how to ensure people’s safety. These included checks on the environment and assessments which identified how the risks to people were minimised. Specific care plans had been developed where people displayed behaviour that was challenging to others. These plans guided staff so that they provided support in a consistent and positive way, which protected people’s dignity and rights.
People were supported by sufficient numbers of staff. A thorough recruitment process was in place. People living at Paddock House were involved in making decisions about who was employed in the service. The recruitment process ensured staff recruited had the right skills and experience and were safe to work with people who used the service. Staff understood their roles and responsibilities and received training which gave them the skills, knowledge and confidence to carry out their duties. Staff demonstrated that they were competent in delivering safe and effective care which met people’s needs.
The interaction between staff and people was warm, caring and friendly. People were relaxed with staff and confident to approach them throughout the day. Staff treated people kindly and were emotionally supportive where people showed signs of distress. People were supported to maintain links with the community and participate in meaningful activities that interested them and met their individual needs.
Staff had a good knowledge of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) legislation, and whether these needed to be considered for people who lived at the service. Documentation in people’s care plans showed that when decisions had been made about a person’s care, where they lacked capacity, these had been made in the person’s best interests. Changes to the law regarding the DoLS were understood and appropriate referrals had been made to the local authority to make sure people’s legal rights were protected.
People and their relatives were involved in the assessment and planning of their care. This ensured staff provided care and where required treatment in a way that people wanted to be supported, and cared for. People were able to discuss their health needs with staff and had contact with the GP and other health professionals, as needed. People were protected from the risks associated with eating and drinking. People spoke positively about the choice and quality of food available.
The registered manager demonstrated clear management and leadership. They were knowledgeable and inspired confidence in the staff team, and led by example. The registered manager had a proactive approach to developing a positive culture in the service. Staff understood and consistently applied the vision and values of the service. The registered manager had signed up to the ‘Going the Extra Mile’ (Gem) Awards which aimed to recognise and celebrate good practice.
The provider had systems in place which were used to continuously assess and monitor the quality of the service, including recording and managing complaints and safeguarding concerns. Incidents and accidents were monitored and management took steps to learn from such events and put measures in place which meant they were less likely to happen again.