The Paddocks

Updated 18 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

The Paddocks is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 of this information to plan our inspection.

During the inspection

Not everyone who used the service was able or wished to speak with us during the inspection. We spoke with one person who used the service about their experience of the care provided. We spoke with six members of staff including the registered manager, regional manager, regional quality manager, a senior support worker, a support worker and an agency member of staff.

We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

Following the inspection, we spoke with a member of the local authority’s contracts team about the service and the ongoing work being undertaken to improve the quality of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 18 October 2019

About the service

The Paddocks is a residential care home providing personal and nursing care to seven people living with a learning disability or mental health condition at the time of the inspection. The service can support up to seven people.

The Paddocks is an adapted bungalow situated on a campus style service in rural Lincolnshire. There are several other houses and bungalows located on the same site and a shared administration office. People living at The Paddocks have their own room and access to a range of shared facilities. They can also use a range of facilities in the grounds of the complex.

Services for people with learning disabilities and or autism are supported

The service takes note of the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service is located on a campus style community in a highly rural area of Lincolnshire and as such would not fit with current best practice guidance which suggests small local services, integrated with the community. However, the size of the service having a negative impact on people was mitigated by the use of individual buildings. Staff supporting people did not wear a uniform or any identifying clothing that suggested they were care staff when coming and going with people, and people were supported to have access to local community facilities and services.

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

Systems were in place to ensure people were protected from abuse and investigate any concerns. Risks linked to people’s care were considered and monitored. Environmental risks were considered. There had been some issues with staff recruitment over previous months, but people received care from staff who knew them well and had relevant experience. We have made a recommendation about maintaining staffing levels. People were supported appropriately with their medicines.

People’s care was based on an assessment of their needs and their choices. Staff had access to arrange of training and support. We have made a recommendation about the provider reviewing how training in certain areas is delivered. People were supported to regularly access health care service to maintain their wellbeing.

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.

The service had regard for the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service broadly reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having opportunities to gain new skills and become more independent.

People were well supported by staff who had a good understanding of their individual needs and preferences. There was some evidence people were supported to make day to day decisions, however, it was not always clear that people had been given meaningful opportunity to participate in care decisions. We have made a recommendation about this. People’s privacy and dignity were respected and supported.

People’s care plans contained good detail about how they should be supported, and we witnessed staff following this guidance. Care plans were very complicated and new care plans were being introduced by the provider. Staff understood people’s communication needs. Alternative communication methods were not always considered. We have made a recommendation about this. People were supported to engage in a range of activities. There had been no recent formal complaints recorded. Information on people’s end of life choices were recorded, as appropriate.

Staff and management were focussed in trying to ensure care and support was based on people’s individual needs and personal choices. Some staff felt management were not always immediately available and felt more immediate support could be increased. Appropriate checks and quality audits were undertaken. There was some evidence of people being involved in the running of the service, but this could be better facilitated.

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

Rating at last inspection The last rating for this service was good (published 23 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

We have made some recommendations for the provider to consider that may help improve the quality of care offered.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Paddocks on our website at www.cqc.org.uk.

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.