The Paddock is registered to provide accommodation for 4 people who require support and personal care, due to an acquired brain injury. The service operates in partnership with The Woodmill, an acute rehabilitation service, which forms part of the nationwide rehabilitation support services provided by The Brain Injury Rehabilitation Trust (BIRT). People using the service are supported with their rehabilitation by the therapy and clinical teams at The Woodmill. This unannounced inspection was carried out on 21 and 22 July 2016. At the last inspection on 21 January 2014 we found the provider met the regulations we looked at.
At the time of the inspection there were three people using the service. The service aims to support people to live as independently as possible.
A registered manager was in place and they were present on the days of the inspection. The registered manager was also registered as the manager of two other small community based residential services. They divided their working hours between the services. 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.’
People were very happy with the care and support they received. They said they were safe at The Paddock. People described the good relationships they had developed with staff and other people living at the service. One person said, “It is lovely here…I am really delighted with it…” There was a relaxed and homely atmosphere at the service. Staff were motivated and passionate about providing good care and people were relaxed around staff.
People said they found the staff caring. Staff demonstrated a caring and compassionate approach towards people and they ensured people’s privacy and dignity was respected at all times. Staff were knowledgeable about people and spoke about them with understanding and affection. People had opportunities to participate in a range of different social and therapeutic activities and were supported to access the local community.
There were systems and processes in place to protect people from the risk of harm. Staff were aware of issues relating to safeguarding, and could describe the action to take should they have any concerns or should concerns be reported to them. Plans were in place to minimise identified risks. People were assisted to live as safely as possible whilst supporting their rehabilitation and independence. People's medicines were managed and stored appropriately.
There were sufficient staff on duty at all times with the right skills to ensure people received the care and support they required. Recruitment practices were safe and relevant checks had been completed to protect people from unsuitable staff.
People were supported to maintain good health. Their physical and mental health needs were closely monitored. People had access to healthcare services as well as input from the therapy team (clinical psychology; occupational therapy; physiotherapy and speech and language therapy) to support their continue rehabilitation. People were provided with a varied diet. They said they enjoyed the food and there were always sufficient amounts of food and drink available to them.
People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people's capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).
There was a collaborative culture within the service. People using the service and staff were able to contribute ideas and suggestions. The provider obtained regular feedback about the quality of the care and support provided from people using the service and staff.
The leadership and management of the service ensured the delivery of personalised care and support. Systems were in place to monitor the quality of the service. Any issues identified for improvement were resolved in a timely way. The ethos of the service supported an open and learning culture.