CQC report explained · a residential care home
What the CQC found at Paddock Lodge Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Most medicines, safeguarding arrangements, staffing and infection control were managed safely. However, records for some medicines were incomplete, some risk assessments needed updating, and some safety work had not been completed promptly.
- Effective?
- Good
- This question was not inspected during this focused inspection. The rating from the last comprehensive inspection was used when calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused inspection. The report says the inspection covered Safe, Responsive and Well-led.
- Responsive?
- Good
- Care was usually person-centred and relatives felt welcome and able to raise concerns. Activities were limited, and some care plans and communication information did not fully reflect people's needs.
- Well-led?
- Good
- The management team had introduced stronger quality checks and improvement plans. Staff felt supported, and people and relatives described the manager and staff as kind and approachable.
What inspectors found, August 2023
Rated Good overall; inspectors found kind, responsive care, but safety still Requires Improvement because of medicines and risk-record shortfalls.
This was an unannounced focused inspection on 17 July and 8 August 2023. Inspectors spoke with people, relatives and staff, observed care, and checked care, medicine, recruitment and management records.
The home was rated Good overall. Responsive and well-led were rated Good. Safe remained Requires Improvement. Most medicines were managed properly, but records for thickener powder and pain patches were incomplete. Some risk assessments and safety actions also needed updating or faster completion. The provider dealt with several issues during the inspection.
The service had improved since the previous inspection. It was no longer in breach of the regulations about risk management and governance. However, the inspection found limited activities, and some care plans did not fully reflect people's current needs.
Kind and attentive staff
People and relatives described staff as kind and caring. Inspectors saw staff responding attentively to people's needs.
“Our observations reflected people's feedback and we saw staff were attentive and responsive to people's needs.” from the report
Improved leadership
The home had stronger systems to identify risks, monitor quality and track improvement actions. It was no longer in breach of the previous governance regulation.
“The provider had introduced a more robust system to identify and manage risks to the quality of the service.” from the report
Safeguarding and recruitment
People were protected from abuse, and staff understood how to report concerns. Recruitment checks, including checks with the Disclosure and Barring Service, were completed.
“People were protected from the risk of abuse.” from the report
Improved responsiveness
Responsive care improved from Requires Improvement at the last comprehensive inspection to Good. Care was usually planned around people's needs and preferences.
“Care was usually planned and delivered in a person-centred way.” from the report
Medicine records
needs fixingRecords did not always show that thickener powder had been used correctly or that pain patches had been applied to different body areas as instructed. Inspectors made two recommendations about medicine management.
“A record was not in place to show the patch had been applied correctly.” from the report
Risk records and safety actions
needs fixingTwo people's risk assessments needed updating. Some actions following a food hygiene inspection had not been completed promptly, although the work was completed by the second visit.
“Regular checks of the premises and equipment were carried out although we saw actions to address some potential risks had not been addressed promptly.” from the report
Limited activities
minorPeople gave mixed feedback about activities, and inspectors saw only limited activity during both inspection days. The management team said it would review the activities system.
“The service had an activity programme although on both days of the inspection this was limited.” from the report
Care planning details
needs fixingSome care plans did not fully describe people's current needs, including bathing, showering, nutrition and communication. People's involvement in care planning was also limited.
“However, we saw examples where there were shortfalls in how the needs of different people were identified.” from the report
- 01How do you now record and check the use of thickener powder and the application sites for pain patches?
- 02How often are risk assessments and care plans reviewed, and how do you involve the person and their family?
- 03What activities are currently available, including outside activities and quizzes?
- 04How do you make sure actions from food hygiene and other safety checks are completed promptly?
- 05Has the manager applied to become the registered manager, and what is the current position?
This was an unannounced focused inspection of Safe, Responsive and Well-led; Effective and Caring were not inspected and their previous ratings were used to calculate the overall rating. This explanation was written from the published report of 19 August 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, April 2022
Rated Requires Improvement overall; inspectors found safety shortfalls and Inadequate leadership, with risks not always identified or acted on.
This was an unannounced inspection on 03 November 2021. Two inspectors visited, an Expert by Experience spoke with relatives by phone, and the inspection included discussions with people, relatives and staff and checks of care, medicines, training and management records.
The home was not always safe. Inspectors found an unresolved fire alarm fault, other environmental risks, infection control problems, concerns about medicines records and staff working very long shifts. People said they felt safe, and medicines were usually given as prescribed, but important checks had missed problems.
Leadership was rated Inadequate. The provider's audits and records did not reliably identify risks, show action taken or reflect people's feedback. Visiting restrictions were also found to be tighter than government guidance at the time, and the provider was asked to review its visiting arrangements.
The overall rating was Requires Improvement. Safe stayed at Requires Improvement, while well-led fell from Requires Improvement at the previous inspection to Inadequate. The home was still in breach of Regulation 12 and was also in breach of Regulation 17.
People said they felt safe
People and relatives told inspectors they felt safe living in the home.
“People we spoke with said they felt safe living at Paddock Lodge and their relatives confirmed this.” from the report
Kind medicines support
Inspectors saw medicines being administered in a caring and compassionate manner. Controlled drug stocks matched the records checked.
“We observed the administration of medicines and saw this was done in a caring and compassionate manner.” from the report
Recruitment checks
The recruitment files reviewed showed that appropriate checks had been completed before two staff started working with vulnerable adults.
“We looked at recruitment records for two members of staff and found appropriate checks had been carried out before these staff started working with vulnerable adults.” from the report
Some environmental improvements
New bedroom furniture had been fitted for 15 people, and the provider said a redecoration programme was near completion.
“Following our inspection, the nominated individual provided evidence and told us a programme of redecoration was near completion and 'new or nearly new furniture' was in all bedrooms.” from the report
Fire and environmental risks
seriousThe fire panel showed a fault for around two weeks, and other risks included overloaded storage near a light fitting, a cellar door bolt and a trip hazard. These issues led to a breach of Regulation 12.
“We could not be assured the fire panel would function in all areas of the home whilst the fault was showing.” from the report
Poor management oversight
seriousAudits and management records did not reliably identify problems or show what action was needed. This led to a breach of Regulation 17 and a warning notice.
“Systems of audit to identify risks were not effective and records were not sufficiently detailed.” from the report
Medicines records
seriousA time-critical medicine was not clearly recorded as given at the prescribed time. Allergies were missing from three people's medication front sheets.
“There was nothing recorded on this person's medicine administration record to show they had received this as prescribed.” from the report
Infection control
needs fixingSocial distancing was not maintained in communal areas, some basins were not sufficiently clean and bedding was changed without properly cleaning the mattress.
“We found some bedrooms where the basins had not been sufficiently cleaned.” from the report
Visiting restrictions
needs fixingRelatives reported limits on visit length, times and locations, including not being able to visit bedrooms. Inspectors found these restrictions went beyond government guidance at the time.
“Relatives told us they were restricted to 30 minute visits and they were not able to visit people in their bedrooms.” from the report
- 01What has been done to make sure the fire alarm and other environmental risks are checked and repaired promptly?
- 02How do you now check that time-critical medicines are given at the right time and that allergy information is complete?
- 03What changes have been made to infection control, including cleaning basins, mattresses and communal areas?
- 04How are staff hours monitored to prevent unsafe consecutive or double shifts?
- 05What are the current visiting arrangements, including visit length, evenings, weekends and visits in residents' bedrooms?
This inspection focused on the Safe and well-led key questions because of concerns about visiting, management and safety; the report gave no new ratings for Effective, Caring or Responsive. This explanation was written from the published report of 1 April 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Paddock Lodge Care Home
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- August 2023Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2022Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Inadequate
- January 2020Requires improvementSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- November 2018
Registered with the Care Quality Commission on 27 November 2018.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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