The Paddocks

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Staff were recruited safely to ensure they were suitable to work with vulnerable people. Lessons were learnt following incidents and accidents to improve the service. Some improvements were required to ensure safeguarding systems were robust. There were enough staff to support people safely. Some parts of the kitchen needed improvements to minimise the spread of infections. Medicines were being managed safely. Premises safety checks had been carried out. Staff were supported through supervisions. However, required training in some areas to consistently perform their roles effectively.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The home manager explained the process in place to ensure people were admitted into the home safely. Staff told us how they supported people safely to move in between services safely such as with healthcare appointments. A relative told us, “The staff work well. They have worked well with the GP to make arrangement if [person] becomes upset.” Another relative commented, “Yes, staff support [person] well with health appointment, they go above to ensure that [person] gets the support [person] needs."

At our last inspection we found incidents were not being shared with staff to learn from lessons and we found the providers accident and incident was not being followed. This was a breach of Regulation 12 (Safe Care & Treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection, we found learning was being shared with staff. We saw evidence of discussions within management meetings highlighting incidents occurring in the service. Actions were discussed within team meetings on how to support people safely and there was evidence the provider saw the necessity of learning lessons when things went wrong. We found that daily reporting and recording was detailed and there was evidence that the management were discussing this to learn from lessons. However, we noted the level of incidents relating to people’s anxieties was high. The home manager told us they were working to minimise incidents and referral to the psychologist had been made where possible and they were looking at involving consultants to help look at ways to develop and manage people anxieties and incidents.

The home manager explained the process in place to ensure people were admitted into the home safely. Staff told us how they supported people safely to move in between services safely such as with hospital appointments. A relative told us, “The staff work well. They have worked well with the GP to make arrangement if [person] becomes upset.” Another relative commented, “Yes, staff support [person] well with health appointment, they go above to ensure that [person] gets the support [person] needs."

Systems were in place to ensure people were supported to move between services safely, this included visits to the placements whereby a person was moving to a new home, regular review of their needs and visits to the home from staff of the new placement. A relative told us, “[Person] was given 5 day’s notice, from the last home. However, the staff at this home was very good and supportive. The management has been very supportive.” People had access to a number of health services and were supported to access these services such as GP and hospital appointments safely. Health records were in place that included people’s support needs and background should they needed to go hospital, which ensured they can receive safe and effective support at hospitals.

Relatives told us people were safe living at the home. A relative commented, “[Person] comes from a closing service, which caused a lot of stress. The staff have collaborated very closely with [person], we have monthly call with the manager for updates and we can call anytime.” Another relative commented, “I visit anytime and without telling staff so I can see how things are, which has been very positive.”

Staff knew about safeguarding processes and had received training in this area. Staff were able to tell us the importance of reporting any concerns to the management team. Staff also felt they could be open to the management team if they had any concerns. The home manager checked staff competency on safeguarding processes through questions and scenarios. They home manager told us, “I test staff knowledge and staff do a mock test, so staff are clear on how to report to the local authority.”

Observation showed that people felt safe and comfortable at the home and had a positive relationship with staff. We also saw QR code displayed at the home, which meant that relative could scan the code, which provided details on how to report safeguarding concerns. We saw a person supported to go out in the home’s own transport during our assessment. The home has a designated driver, which allows accompanying staff to focus on keeping people safe whilst out in the community.

Safeguarding systems were in place. A safeguarding policy was in place that detailed the types of abuse and how to escalate concerns if staff suspected or saw abuse to ensure people were protected. We saw evidence that the home manager arranged workshops for staff to attend regarding safeguarding. The home manager has been working closely with staff in regard to reporting safeguarding incidents. Safeguarding referrals had been made when needed and action taken to ensure people were safe. However, we saw some instances whereby safeguarding investigations did not detail actions taken to minimise risk of reoccurrence and ensure people were safe at all times.

Relatives told us that people were supported safely, which included minimising risks to ensure people were safe. A relative told us, “Yes, the staff do very well, they support [person] well.” Another relative commented, “Yes, they support [person] well and the new manager is doing an excellent job.”

The home manager and staff were aware of the importance of having risk assessments in place to ensure risks were minimised and people received safe care and support at all times. The home manager told us, “I work with staff on shifts and carry out observations on how staff meet people’s needs. From there I ensure that people’s risk is recorded correctly and staff are clear on how to support people in the right way.”

We observed that staff had good knowledge about people and supported people safely such as ensuring people were able to mobilise and eat their food safely. At the time of our visit, we saw people engaged in activities within the home. We saw staff encouraging people with activities whilst helping them to remain safe. People were involved with support from staff in everyday chores around the home, which included activities in the kitchen, preparing food and other necessary tasks such as doing their laundry.

Sufficient risk assessments were in place to ensure people received safe care. People had detailed risk assessments in place describing the support they needed to keep safe. There were risk assessments to ensure people were safe when being supported, such as positive behaviour support plans, which included triggers and measures to support people when they were anxious. Additional risk assessments included skin conditions and out in the community. Whilst the care plans, including risk assessments were well written we could not see how the provider involved people in the development of these plans as they were not accessible to the people living in the service. The home manager has informed us that they are setting up a project where a staff member is going to look at new technology and how they can work with people by involving them. We saw a positive behaviour support plan for one person living in the home. These plans help staff to understand and anticipate behaviour. However, we noted that the positive behaviour support plan we saw was written in 2021 and had not been reviewed. The home manager has advised that the reason for this not being reviewed is that the local authority had completed this assessment, which the home had requested for them to review. However, in the meantime the home manager has reviewed this until the local authority behavioural support team has reviewed the documentation.

People lived in a safe environment. Relatives we spoke to had no concerns about the safety of the home.

The home manager and staff told us the home has improved since our last inspection and it is safe to live in with regular checks carried out to ensure the premises was safe.

We observed the home was safe to live in. The home was clean and tidy, which ensured people were able to move around the home safely.

The premises and environment met the needs of people who used the service and were accessible. People were involved on the decisions about the home, which included decorating the home according to their preferences. Premises such as gas safety and fire safety checks had been carried out to ensure the premises was safe to live in. Equipment’s were checked to ensure they were safe. There was a spacious communal area. There was a garden if people wanted to go outside. People’s rooms were decorated according to their preferences.

There was enough staff to support people safely. Relatives we spoke to had no concerns about staff that supported people and with staffing. A relative told us, “[Person] has [staff support] and they always have the right staff on shift.” Another relative told us, “They support [person] in the way [person] needs support and the manager is so good. The staff know what they are doing and they care about the people.”

Staff were supported in their role. The home manager told us that staff were supported through training, supervisions and regular contact to ensure staff can receive support. Staff told us that they received regular supervisions and support from the home manager. One staff said they had an induction and shadowed experience staff before working by themselves. The home manager told us, “We carry a needs assessments and regular reviews to ensure people are being reviewed as needed.”

There was enough staff to support people safely. We observed that staff knew people well and supported them safely and responded to people's request promptly.

There were appropriate numbers of staff on duty to support people safely. Staff rotas confirmed there were enough staff to support people safely. Records showed relevant pre-employment checks, such as criminal record checks, references and proof of the person’s identity had been carried out. Staff had completed key training such as on safeguarding and learning disabilities. However further training was required such as on positive behaviour support and epilepsy to ensure staff can consistently perform their roles effectively. Regular supervisions and appraisals had been carried out to ensure staff were supported. A relative told us, “Staff are very good they are good at their job.”

Systems were in place to prevent and minimise the spread of infection to ensure people experience was safe. A relative told us, “Yes, the staff do a good job to keep the home clean and safe.”

The home manager and staff told us the home was kept clean to minimise risks of infection. Staff told us they cleaned daily and followed a cleaning schedule to ensure the home was clean and tidy.

We observed the home to be clean and tidy in general. A cleaning rota was in place that evidenced regular cleaning was being carried out. However, we observed some part of the kitchen were not clean and required improvement.

An infection control policy was in place and staff had been trained on infection control. Personal Protective Equipment (PPE) was readily available and staff confirmed they had access to PPE when needed. Food hygiene was being maintained. We observed food that had been opened was sealed and labelled on date it was open. Infection control audits were being carried out. However, records showed the audits were not completed in full as the scoring section that determined if standards were being met was blank. We also found some parts of the kitchen was not clean.

People received their medicines safely. A relative told us, “The staff support [person] with medication. There have been no issues with medication.” Another relative commented, “Staff support my [person] very well with their medication.”

Staff told us they were confident of managing medicines. The home manager told us, “We use an electronic system that can be easily audited and alerts the management team of any concerns.” The home manager was able to demonstrate the process in ensuring medicines were managed safely such as training being delivered to staff, competency assessments being carried out and regular checks made on medicine administration and records.

Medicine Administration Records (MARs) showed that medicines had been administered as prescribed. Medicine audits were carried out to ensure people received their medicines safely. Staff had also been trained in medicines management and had competency assessments to ensure they were competent to manage medicines. We observed the medicines were securely stored. Medicine audits were also completed to ensure medicine were managed safely.