Padgate House

Updated 17 March 2020

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the registered provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by one inspector and an ‘Expert by Experience’. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type:

Padgate House is a ‘care home’. People in care homes receive accommodation and nursing or personal care. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with CQC. This means that they and the registered provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

The inspection was unannounced.

What we did:

Before the inspection we reviewed the information we held about the service. This included any statutory notifications sent to us by the registered provider about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law. We also contacted local commissioners of the service to gain their views. We used the information the provider sent us in the ‘provider information return’. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to formulate a ‘planning tool’; this helped us to identify key areas we needed to focus on during the inspection.

During the inspection we spoke with the registered manager, one physiotherapist, one occupational therapist, one social worker, one nurse, six members of care staff, one external healthcare professional, 14 people who were receiving support and 11 visiting relatives.

We also looked at care records of three people receiving support, four staff recruitment files, medication records, and other records and documentation relating to the management and quality monitoring of the service.

In addition, a Short Observational Framework for Inspection (SOFI) tool was used. SOFI is a way of observing care to help us understand the experiences of people who could not talk with us.

Updated 17 March 2020

About the service:

Padgate House is a single-storey 'care home' that provides intermediate care, nursing and rehabilitation for up to 31 people. Padgate House also supports up to four people requiring neurological rehabilitation.

The service provides short term support in an intermediate care setting to help people regain daily living skills and independence. At the time of the inspection Padgate House was supporting 35 people. The service is provided jointly by Warrington Borough Council and Bridgewater NHS Foundation Trust.

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

All staff were supported with a thorough induction and people told us they received effective care and support by staff who were familiar with their support needs. We did however find that not all staff were supported with annual refresher training. We recommend that the provider reviews and strengthens training compliance.

Quality assurance systems and processes were in place to monitor the quality and safety of care people received. Although, some areas require further review and assessment as to ensure people are receiving consistent high-quality, person-centred care.

People received medication support by staff who had been appropriately trained and regularly had their competency levels checked. However, we identified that not all prescription medications were safely stored as per medication policy. This was immediately addressed by the registered manager during the inspection.

Staffing levels and recruitment procedures remained safe. People received a safe level of care by appropriately recruited staff, staffing levels were closely monitored and people received support in a timely and effective manner.

People’s level of risk was appropriately assessed, and effective support measures were put in place from the outset. Care records contained up to date and consistent information. There were effective systems in place to ensure all staff and records were updated with the most relevant and timely information about people’s care and support needs.

People continued to live in a safe environment. Health and safety monitoring tools and checks were in place, regulatory compliance certificates were up to date and regularly renewed and people had personal emergency evacuation plans (PEEPs) in place.

People received person-centred care; the care and support they received was tailored around individual needs, wishes and preferences. People and relatives told us that staff were attentive, kind and delivered care that was considerate and compassionate. One person told us, “[The staff] are kind, patient and very helpful as well. They’re very nice, personal but not over-familiar.”

Safeguarding and whistleblowing procedures were safely in place. Staff understood the importance of keeping people safe and were familiar with the reporting procedures they needed to follow.

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.

Dedicated physiotherapists and occupational therapists provided therapeutic support to people living at Padgate House. Therapeutic activities helped to build and develop people’s confidence, independence and living skills. Some feedback suggested that more stimulating activities could be provided of a weekend.

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

Rating at last inspection and update:

The last rating for this service was ‘good' (published 22 August 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.