5 December 2022
During an inspection looking at part of the service
The Paddocks is a residential care home providing accommodation and personal care to 5 people at the time of the inspection. The service can support up to 8 people.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right support:
The Paddocks was located in a rural area of Doncaster and people were able to access community facilities and had links with local villages and shops. The location enabled and supported people to access nature and countryside walks. The registered manager ensured there was a culture of person-centred care and 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 service supported this practice.
Right care:
Care was person-centred and promoted people's dignity, privacy and human rights. Education and learning were promoted. Medicines were not always managed safely and information was not always correct in medication sheets. Risk assessments were in place and detailed, however, plans were not always followed by staff. For example, where people were at risk of ingesting hazardous substances, cleaning products were not always locked away. Some parts of the service were not clean enough and presented a risk to infection prevention and control. The provider was in breach of regulations in relation to safe care and treatment. Following the inspection, the registered manager took immediate action to address the areas that needed improvement.
Right culture:
The ethos, values, attitudes and behaviours of leaders and care staff ensured people using services were leading confident, inclusive and empowered lives. There was a positive culture of person-centred care for people living at The Paddocks. People were engaged and involved in developing and improving their homes and the service. Families told us they are involved in care planning and reviews and said they were satisfied with communication and engagement from the service. Families felt that the staff promoted a safe, consistent and predictable atmosphere which met people's individual needs and told us the registered manager was approachable and good at listening. Compliance and quality monitoring systems needed to be further strengthened and embedded into practice. The outcomes of audits and checks and needed to be regularly reviewed to identify compliance, lessons learned and areas for improvement. The provider was in breach of regulations in relation to governance of the service. Following the inspection, the registered manager took immediate action to address the areas that needed improvement.
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 2 June 2021) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
At this inspection we found the provider remained in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 26 April 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the governance of the service.
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 remains requires improvement. 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
We have identified breaches in relation to medicines management, safe storage of cleaning products and 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.