We carried out a review of the data available to us about The Paddocks 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 The Paddocks, you can give feedback on this 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.
At the last inspection the service was rated ‘Good’.
We carried out this unannounced inspection at the service on 1 February 2017. At this inspection we found that the service had maintained its ‘Good’ rating.
People were supported to have as much choice and control over their lives as they were able to. They were supported in the least restrictive way possible. The systems and policies in the service supported this practice.
Steps had been taken to reduce the risk of people having accidents and staff knew how to keep people safe from the risk of abuse. There were enough safely recruited staff on duty to meet people’s needs. Medicines were safely managed.
People received their care from staff who were trained and supported to do so in the right way. They received the support they needed to access appropriate healthcare services and to eat and drink enough to stay well.
People were treated with care and kindness. Their privacy was maintained and their dignity promoted by staff who understood the importance of this. Confidentiality of personal information was maintained.
People reliably received the individualised support they wanted and needed. This included support to maintain and develop their social interests and hobbies. There was a system in place to respond to and resolve complaints.
People had benefited from staff acting upon good practice guidance. Quality checks had been completed to ensure people received safe and reliable support.
Further information is in the detailed findings below.
We inspected The Paddocks on 15 October 2014. The inspection was unannounced. The last inspection took place on 17 February 2014 during which we found there were no breaches in the regulations.
The Paddocks provides care and support for up to seven people who experience learning disabilities and needs within the autistic spectrum. It forms part of a larger complex of homes provided by Autism Care (UK) Limited, in the Scopwick area of Lincolnshire. Seven people lived at the home; six of whom were at home during the inspection.
There was a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
CQC is required by law to monitor the operation of the Mental Capacity Act, 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of the inspection five people who used the service had their freedom restricted and the provider had acted in accordance with the Mental Capacity Act, 2005 DoLS.
People told us or indicated through sign language that they felt safe living at the home and they liked living there. There were systems and arrangements in place to make sure people were kept safe and had their rights protected.
There was an open and inclusive culture within the home which enabled people to be a part of decision making processes, develop as individuals and lead a life that was meaningful to them. We saw examples of people being supported with kindness, respect and dignity throughout the inspection.
Although some people had different ways of communicating the provider, manager and staff had put systems in place to ensure that everyone was able to contribute to their care and support in any way they could. People benefitted from access to appropriate healthcare services and good nutritional arrangements.
The provider and manager ensured that everyone who was important in people’s lives were involved in their care and support and able to contribute to the development of the services they provided.
People were supported by staff who knew and respected them as individuals and were trained to use support methods that were nationally recognised as good practice. Staff were encouraged to express their views and opinions and supported to continually develop their skills in line with national guidance about good practice.
There were arrangements in place to continually assess and monitor the quality and effectiveness of the services provided for people. The arrangements enabled the provider and manager to take appropriate actions to develop the services and learn lessons from events that took place in the home.
Before we undertook our visit we reviewed all of the information we had about the service. During our visit we spoke with staff about the work they did and listened to people when they talked about what they liked to do.
Staff were responsive and supported people in a respectful and dignified way. Staff showed us they understood each person's way of communicating their needs, wishes and choices.
We found people were provided with the choice of a variety of food and drink that met their individual needs. One person commented that they looked forward to their lunch saying, 'I am having egg and tomato and that's my choice.'
Staff had been given the right amount of training and support which helped them understand peoples' complex needs. Staff told us this enabled them to feel confident in carrying out their roles.
We looked at the statement of purpose and found this reflected the current service provision. Overall we found the service was well led and the home owner and manager had a system in place to respond to any concerns or complaints they received.
Where they were able to people told us things like 'I choose what I want to do', 'Like living here' and 'Good staff, I like them.'
We saw that people were supported in a way that closely followed their care plans.
People were given support to make choices and decisions for themselves wherever they could do so, and staff clearly understood each person's way of communicating their needs, wishes and choices. We saw that people had a good rapport with staff and appeared to be comfortable and confident when interacting with them.
Two people were able to indicate to us by using sign language that they liked living in the home, and they liked the staff that supported them.
We saw that staff supported them in a respectful and dignified way, and that they followed the care that was set out in people's plans.
We saw that people were given support to make choices and decisions for themselves wherever they could do so.