CQC report explained · a nursing home
What the CQC found at The Paddocks Care Home
Rated Inadequate: inspectors found the home performing badly and the CQC has taken enforcement action.
What inspectors found, March 2021
Rated Requires Improvement and still in special measures; inspectors found safety shortfalls and inadequate leadership.
This was a focused inspection of Safe and Well-led. Inspectors visited over five days in October 2020, observed care, spoke with people, relatives and staff, and checked records, medicines, recruitment and management systems.
The home had enough staff to keep people safe, and people usually received their medicines on time. However, some risks were not properly managed. These included unsecured creams and razors, an unsafe wardrobe, poor use of protective equipment and gaps in infection control.
Inspectors also found that a movement sensor was used without the required consent or best-interests process. The home's checks and audits did not reliably find or fix problems. Important incidents had not always been reported to CQC.
The overall rating improved from Inadequate to Requires Improvement. Safe improved to Requires Improvement, but Well-led remained Inadequate. The home remains in special measures because it had been rated Inadequate at two consecutive inspections.
Enough staff for safety
Inspectors found enough staff to keep people safe, and staff responded promptly to requests for help on the inspection day.
“On the day of our inspection visit, staff responded to people's request for assistance promptly.” from the report
Medicines usually given safely
People said they received their medicines when needed. Inspectors observed staff using good practice when giving medicines.
“People told us they received their medicines when they needed them and records confirmed this.” from the report
People felt safe
People and relatives told inspectors they felt safe living in the home. Staff also understood how to report suspected abuse.
“People told us they felt safe living in the home and relatives agreed with this.” from the report
Pandemic communication
People and relatives said they were kept informed about visiting restrictions and changes during the pandemic.
“People and relatives told us they had been kept informed about the pandemic and visiting policy.” from the report
Unmanaged safety risks
seriousSome creams, toiletries and razors were left unsecured. A wardrobe was not fixed safely and could move when touched.
“Toiletries, prescribed creams and razors were found in people's rooms on the dementia unit, either left out on furniture or in a cabinet that was unlocked.” from the report
Unlawful restriction
seriousA movement sensor was used without proper consent or a best-interests assessment. This led to staff entering one person's room despite their wish for privacy.
“People's consent for the use of the PIR had not been sought and where it was felt they lacked capacity to consent, the principles of the Mental Capacity Act (2005) had not been followed.” from the report
Weak management checks
needs fixingAudits did not find several problems, including gaps in care records, unsafe equipment monitoring and infection-control practice. Lessons were not always learned from earlier concerns.
“Regular audits conducted had not identified several issues we found during the inspection to help drive improvement.” from the report
Incidents not reported
seriousThe provider did not tell CQC about several incidents that the law required it to report, including abuse, serious injuries and a deprivation of liberty.
“The provider had failed to notify us of several incidents that we are required to be told about by law.” from the report
Infection-control gaps
seriousEquipment was not always decontaminated between people, and protective equipment was not always worn correctly. Visitor checks were also not completed in line with guidance.
“Staff did not decontaminate a sling or standaid when using them between two people and they did not always wear PPE correctly in line with current guidance.” from the report
Bathing choice not restored
needs fixingOne person had been unable to use a bath for many weeks because staff believed it was broken, even though it had been repaired. They received strip washes instead.
“I have been unable to have a bath due to a fault with one of the taps. I have had to beg for a bath which I really miss.” from the report
- 01What conditions has CQC placed on the registration, and what evidence can you show that they have been met?
- 02How are creams, toiletries and razors now kept secure, particularly on the dementia unit?
- 03How do you now assess consent and best interests before using movement sensors or other restrictions?
- 04What systems now ensure all accidents, abuse concerns, serious injuries and deprivation-of-liberty incidents are reported to CQC?
- 05How are infection-control practices, equipment cleaning and protective equipment use checked each day?
This was a focused inspection of Safe and Well-led, including infection control; Effective, Caring and Responsive were not inspected and their previous ratings carried over. This explanation was written from the published report of 17 March 2021 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 2020
Rated Inadequate and placed in special measures; inspectors found serious safety and leadership failures despite kind staff and well-managed medicines.
Inspectors visited without notice on 27 February, 28 February and 2 March 2020. They spoke with people living in the home, relatives and staff, and checked care, medicines, recruitment and safety records.
The overall rating fell from Good to Inadequate. Safe and well-led were rated Inadequate. Effective, caring and responsive were rated Requires Improvement. Inspectors found risks that had not been properly identified or acted on, poor records, an unclean main kitchen and weak checks on quality and safety.
Some care was positive. Staff were described as kind and patient. Medicines were generally managed well, safeguarding systems were in place and staff had appropriate training. However, people sometimes waited too long for personal care, records did not always show that care had been given, and people living with dementia had too little meaningful activity.
The home was placed in special measures. The provider was asked for an action plan and will be monitored with the local authority. The provider acted promptly after the inspection, so CQC said it did not take urgent enforcement action at that time.
Kind and patient staff
Inspectors saw staff treat people with patience and kindness. Staff knew people's needs and often supported them sensitively.
“Staff were caring, patient and kind. They went the extra mile and feedback about the staff was very positive.” from the report
Medicines
People received their medicines as prescribed, including medicines that had to be given at a particular time. Storage, stock control and staff competence checks were generally effective.
“People received their medicines, including time sensitive medicines, as prescribed.” from the report
Staff training
Staff had a comprehensive induction, ongoing training, supervision and appraisals. Staff told inspectors they felt supported.
“Staff were skilled and knowledgeable in their roles. They received a comprehensive induction and completed the Care Certificate” from the report
Safeguarding
Staff understood how to recognise and report abuse. Safeguarding referrals were made when needed and one reported incident was managed appropriately.
“Staff received safeguarding training and were able to tell us how they would recognise and report any safeguarding concerns” from the report
Complaints and end of life care
The complaints process was clear and formal complaints had been investigated. End of life wishes were recorded and anticipatory medicines were made available promptly.
“There was an effective complaints policy and procedure in place. People received good end of life care and their wishes regarding the end of their life were recorded.” from the report
Risks were not managed
seriousImportant risks linked to falls, pressure ulcers and choking were missed or not followed through. Inspectors were not assured that people received the right care to reduce these risks.
“This meant people were not safe and were at risk of avoidable harm.” from the report
Unsafe environment and kitchen
seriousInspectors found trip hazards, a blocked fire exit, unsafe storage and a hot uncovered radiator. The main kitchen was visibly dirty and food was not always stored safely.
“The main kitchen, which supplied meals to two units, was not clean.” from the report
Poor care records
seriousRepositioning, food and fluid charts and healthcare records were incomplete or difficult to find. This meant the home could not show that people had always received the care they needed.
“Poor recording systems made it impossible for staff to demonstrate they provided person centred care.” from the report
Delays with personal care
needs fixingSome people said they waited too long for personal care and sometimes had to wait when they needed help. Three people said they had not had baths as regularly as they wished.
“Generally if I press the bell at night they come quite quickly but more than once I couldn't wait and so wet the bed which is very distressing.” from the report
Food and weight concerns
needs fixingFeedback about food was mostly negative. Weight changes were not always investigated, and alternatives or suitable finger foods were not consistently provided.
“People's dietary needs were not always well managed.” from the report
Limited activity for people with dementia
needs fixingPeople on the residential wings had more activities and outings. People living with dementia were often underoccupied, with limited stimulation observed during the inspection.
“On the wing where people were living with dementia there was less stimulation.” from the report
- 01What has been done since the inspection to identify and reduce risks from falls, pressure ulcers and choking?
- 02How do you now make sure repositioning, food and fluid charts and healthcare visits are recorded accurately and can be found easily?
- 03What changes have been made to the main kitchen, food storage and cleaning checks?
- 04How do you make sure people receive personal care, including baths, when they request it?
- 05What activities are now available for people living with dementia, and how do you check that they are not underoccupied?
This was an unannounced inspection covering all five key questions, the premises and the care provided. This explanation was written from the published report of 17 April 2020 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 The Paddocks Care Home
4 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- March 2021Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- April 2020Inadequatedown from GoodSafe: InadequateWell-led: Inadequate
- September 2017Goodstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 13 January 2011.
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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13 live-in carers within about an hour of Norfolk
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £990 to £1,120 a week. 9 can care for a couple. 14 years' experience on average.
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