We carried out a review of the data available to us about Padgate House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Padgate House, you can give feedback on this 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.
The service is provided jointly by Warrington Borough Council and Bridgewater Community Healthcare. On the day of our inspection the service was providing accommodation and nursing care to 33 people.
At the last inspection the service was rated overall good. At this inspection we found the service remained good.
People continued to remain safe from the potential harm of abuse or ill-treatment as staff knew how to recognise and respond to such concerns. People were supported by enough staff to meet their needs. People received their medicines safely.
The provider followed safe recruitment procedures when employing new staff members.
Staff members had the training and skills to meet people’s individual needs.
People had care and support plans that reflected areas of their lives which they needed assistance with. When changes occurred in people’s needs these care and support plans were reviewed to reflect the changes.
People were supported to have choice and control over their lives. They were assisted by staff in the least restrictive way possible. Staff were aware of current guidance which directed their practice and people’s human rights were protected by the staff who supported them.
People received support that continued to be caring and compassionate. Their privacy and dignity was valued by those providing assistance. People were supported by staff at times when they felt anxious or nervous.
Staff members knew people’s support needs and assisted them in the manner they preferred. People and their relatives were encouraged to raise any concerns or complaints. The provider had systems in place to address any issues raised with them.
The management team were approachable and supportive. People were encouraged to be involved in decisions about Padgate House and their suggestions were valued by the provider.
Staff members felt valued as employees and their opinions and ideas were listened to by the provider. The provider had systems in place to monitor the quality of service and where necessary made changes to drive improvements.
Further information is in the detailed findings below.
This inspection was unannounced and took place on the 19 January 2015.
The service was previously inspected in May 2013 when it was found to be meeting all the regulatory requirements which were inspected at that time.
Padgate House provides intermediate care and nursing support for up to 31 people and a further four people requiring neuro rehabilitation. The service provides short term support for up to six weeks in a residential setting to help people regain daily living skills and independence. The service is provided jointly by Warrington Borough Council and Bridgewater Community Healthcare. On the day of our inspection the service was providing accommodation and nursing care to 35 people.
At the time of the inspection there was a registered manager at Padgate House. 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.
During our inspection, people receiving intermediate care at Padgate House were observed to be comfortable and relaxed in the presence of staff. We observed interactions between staff and people using the service to be kind, caring and personalised. We also observed people’s choices were respected and that staff communicated and engaged with people in a polite and courteous manner.
People using the service spoke highly of the standard of care provided. Comments included: “They always ask permission to do things with you and explain what is going to happen”, “They do everything I need. They are always there to help you and I think they are very good”; “They are lovely with you, they call you by your name and from top to bottom it’s been very good”; “The staff are very good. They are always explaining where you are going wrong with your walking and put you right. They are absolutely marvellous. They always knock before they come into my room, they respect my privacy” and “They are trying to get me back on my feet and walking again. I’m happy with the way they treat me, they are very friendly and very nice”.
Examination of records and discussion with staff confirmed staff had access to formal supervision and a range of induction, mandatory and other training that was relevant to individual roles and responsibilities. The training was delivered via e-learning or face to face sessions.
We saw that there were corporate policies and procedures in place relating to the Mental Capacity Act 2005 and Deprivation of Liberties (DoLS) and staff had access to training in this area. This helped to safeguard the rights of the people using the service.
A range of auditing systems had been established to monitor and develop the service. There were also arrangements in place for people at Padgate House to be consulted about their opinions via monthly meetings and to provide feedback via questionnaires on the service provided.
It became clear from discussions with staff that some staff felt there was potential to improve integration between staff employed by the registered provider (Warrington Borough Council) and Bridgewater Community NHS trust. For example, two staff spoken with described the service as “Disjointed”and “Fractured”. Likewise, there was scope for the development of more centralised records and management information systems.
People told us they were happy with the service they received and that they would be happy to raise any concerns they had with the staff team.
People's comments included 'staff are very nice', 'lovely people' and 'very helpful'. People told us that Padgate House was 'very comfortable' and 'nothing was too much trouble.'
Since we last visited the service has made improvements as to how the manage and maintain records relating to people's care and support.
We saw recruitment procedures helped ensure that only people suitable for the role were employed and that staff received training and support for their role.
Systems were in place to regularly assess the quality of the service being delivered to people.
We spoke to seven people using the service during our visit. Most people told us that staff respected their privacy and dignity. Their comments included 'I couldn't be better looked after'; 'I am spoken to well by nurses, they're like friends' and they will change things if you want them to.'
A visiting relative told us 'we would happily pay for this care' and 'my mother is treated with full dignity and respect.'
People told us good things about the food they received. Comments included 'food is very good'; 'food is well cooked and would nourish anybody'; 'food is excellent' and 'food is appetising and you have a choice.' One person told us 'I only have a small appetite so I only ask for small meals.'
A visiting relative told us that that their relative ate their meals in their room and 'the food is nicely served and beautifully presented'. The family member told us that staff asked how much of the meal had been eaten and the relative felt that food consumption was being monitored.
The majority of people told us that they knew who to speak to if they were not happy. One person told us 'I feel safe here and well cared for.' Another person told us that they were reluctant to complain as they were still a patient there.
People who use the service that we spoke to told us that staff were available to help them. Comments included 'I couldn't be better looked after'; 'staff are very pleasant' and 'staff are marvellous.'