Archived: Paddock Lodge

Updated 11 October 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the 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.

This unannounced inspection was carried out on 9 August 2018. The inspection team consisted of two adult social care inspectors. At the time of our inspection there were 21 people living at Paddock Lodge.

Due to the timing of the request for a provider information return (PIR), the registered provider could not be expected to complete this before the inspection commenced. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

Before our inspection, we reviewed all the information we held about the home. We contacted the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

Before our inspection, we received information of concern related to a staff member not having an assessment of their competency to safely administer medicines. You can see what we found and the action taken within this report.

We spoke with a total of six people who lived in the home as well as two relatives who were visiting at the time of our inspection. We also spoke with two area managers, two team leaders, three care assistants, the cook and a visiting health professional.

We reviewed three care plans including their medication, consent to care and treatment as well as the mental capacity assessment and deprivation of liberty safeguarding authorisation for one person. We observed staff interacting and supporting people throughout the inspection which included the lunch time experience. We observed the handover of information regarding people’s care between the day staff and the afternoon staff on the day of the inspection.

Updated 11 October 2018

This was an unannounced inspection carried out on 15 and 21 June 2018.

Paddock Lodge is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Paddock Lodge is registered to provide accommodation for up to 24 people.

This was the first inspection carried out at Paddock Lodge since the provider changed the registration of this service in October 2017.

At the time of our inspection, the registered manager was not available as they were on annual leave. 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. Instead, we were supported by two area managers, one of which was the responsible individual who we have referred to in this report as the ‘registered provider'.

The governance systems used to provide oversight of the service through audits were not effective as the areas of concern we found at this inspection had not been identified or acted on.

During our inspection we found five staff members did not have a current medication competency assessment. Immediately following our inspection, the registered provider sent us evidence to show all staff subsequently had their competency checked.

We saw gaps in the training matrix in some key areas such as safeguarding people from abuse and dementia care. The registered provider showed us staff were booked on to courses to address these gaps. Evidence of supervision support was limited as some staff had received one supervision during 2018.

Staffing levels were sufficient to meet people’s needs. People received their medicines as prescribed, although we saw one staff member responsible for administering medicines did not respond appropriately when a person refused to take their medicines.

Recruitment procedures were checked and found to be safe. Risks to people had been suitably assessed, managed and reviewed. Care plans contained sufficient information for staff to provide effective care.

People were lawfully deprived of their liberty and mental capacity assessments supported this. People were supported by staff to access healthcare services and their dietary needs were being met.

People spoke positively about the assistance they received from staff and we found their privacy and dignity was maintained.

At the time of our inspection, no complaints had been made to the registered provider, although people and relatives knew how to raise concerns.

Staff felt supported by the registered manager who they said was approachable. Meetings with people, their representatives and staff were taking place. A satisfaction survey had been carried out in September 2017.

We have made a recommendation regarding the use of dementia friendly signage to make navigating the building easier for people living with this condition.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. You can see the action we have told the provider to take at the end of this report.