The Paddocks

About the service

The Paddocks is a care home registered to accommodate and support up to 8 people with learning disabilities, autistic people and people with mental health needs. At the time of the inspection, 7 people were living at the home. People living in the home had their own bedrooms and there were shared communal spaces, including lounges, a kitchen and a garden area, all on one floor.

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

The provider had made improvements following our previous inspection, to make the home safer. Improvements were needed to reporting processes to ensure that accidents and incidents were investigated appropriately. We looked at staff meeting minutes, there was no discussion about people's incidents and accidents or how to prevent any future incidents.

Following the inspection, the provider sent us evidence to indicate they had made changes to improve accident and incidents.

Right Support:

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 home supported this practice. The model of care at The Paddocks maximised people's choice, control and independence.

Staff were committed to supporting people in line with their preferences and supported people to receive their medicines safely and as prescribed. People were supported to access healthcare services to promote their wellbeing and help them to live healthy lives.

Staff managed risks to minimise restrictions, focusing on what people could do for themselves. The home had effective infection, prevention and control measures to keep people safe, including good arrangements for keeping the premises clean and hygienic.

Right Care:

Staff delivered care in line with information in people's care plans and recognised models of care for people with a learning disability or autistic people. This ensured people were receiving care tailored to them which promoted a good quality of life.

Staff had training on how to recognise and report abuse and they knew how to apply it. Staff recruitment, induction and training processes promoted safety, including those for agency staff. People were supported by staff who had received a wide range of relevant and good quality training to meet their needs.

Right Culture:

There was a positive culture at the home and people benefited from being supported by happy staff and this was reflected in the atmosphere at the home. Staff told us they enjoyed their job and making a positive difference to someone's life. Systems were in place to apologise to people, and those important to them, when things went wrong.

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 requires improvement (published 29 June 2022) and there were breaches of Regulation 13 (safeguarding service users from abuse and improper treatment) and Regulation 17 (good governance). The provider completed an action plan after the last inspection to show what they would do to improve. At this inspection we found improvements had been made and the provider was no longer in breach of these regulations.

Why we inspected

This was a planned inspection based on the previous rating and when the service was last inspected.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained the same. This is based on the findings at this inspection.

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.

Enforcement and Recommendations

We have identified breach in relation to safe care and treatment at this inspection. We have also made a recommendation to follow best practice guidance around quality assurance.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

About the service

The Paddocks is a care home registered to accommodate and support up to eight people with learning disabilities, autistic people and people with mental health needs. At the time of the inspection, six people were living at the home. The home has one floor level with adapted facilities and en-suite rooms.

People’s experience of using this service

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right support:

The service was one of a small cluster of care homes in a secluded area of farmland that was close to the local town. This meant the service was designed in a way that did not embed people in the community and was not in line with the current principles of Right support, Right care, Right culture. However, the provider ensured people were able to go out as much as possible and were not isolated from the local community. Some people were required to be separated from other people in the home for their own and other people’s safety. Staff did not always follow protocols to report accidents and incidents in the home.

People told us they felt safe. They were supported to maintain a good quality of life, use local services and keep in touch with family and friends. People had control of how their care and support was arranged and were supported to be as independent as possible. People pursued their interests and we observed staff supporting people to go about their daily lives, such as their regular activities and routines. We saw one person watering the garden, people going with staff into town and people going to a day centre and gym, which was next to the home. One person we spoke with was planning to go on holiday with their relatives.

Right care:

People received care and support that was personalised for their needs. People and staff had developed positive relationships with each other and staff were respectful and caring. Care plans were person-centred for people to receive care that met their needs and preferences. Staff understood how to protect people's dignity, privacy and human rights.

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. People's sensory and behaviour support needs were understood and met. Their communication abilities were assessed so that staff could engage and interact with them appropriately.

Right culture:

The values and attitudes of staff and managers in the home helped people to be as independent as possible and feel empowered and positive in their daily lives. However, processes for the continued oversight of incident reporting were not always effective to ensure people received safe care.

People’s equality and diversity needs, such as their cultural background and sexuality were respected. The registered manager monitored the service to check people were safe and received a good standard of care but more oversight of the reporting of incidents in the home was required. Staff were assessed and trained to carry out their roles effectively. Feedback was sought from people and relatives to help make continuous improvements to the service. The home was clean, bright and well furnished.

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

Rating at last inspection

This service was registered with us on 5 March 2021 and this is the first inspection. The last rating for the service under the previous provider was Good, report published on 3 August 2018.

Why we inspected

This inspection was prompted by a review of the information we held about this service. The inspection was also prompted in part by notification of a specific incident that took place in the provider’s other neighbouring service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have identified breaches in relation to safeguarding people from abuse and improper treatment and ensuring there was good governance of the service.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.