9 August 2018
During a routine inspection
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.