CQC report explained · a residential care home
What the CQC found at The Paddocks
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2023
Requires Improvement; inspectors found safer arrangements overall but serious gaps in learning from accidents and incidents.
This was a focused inspection carried out after the previous Requires Improvement rating. Inspectors visited on 26 July 2023 and gathered evidence until 31 July, including records, staff files, medicine records, staff discussions, observations and telephone calls with relatives.
The home had made improvements since the previous inspection. Staff understood safeguarding, risks were assessed, medicines were managed safely, infection control was effective and there were enough trained staff. People were supported to make choices and relatives said they felt people were safe.
However, the home was not consistently learning from accidents and incidents. Records did not show that events were discussed with staff or that action was taken to reduce the risk of them happening again. The provider sent evidence of changes after the inspection, but inspectors still found a breach of Regulation 12.
The overall rating remained Requires Improvement. Safe and Well-led were both rated Requires Improvement. The other three areas were not inspected during this visit, so their previous ratings were used in calculating the overall rating.
Safer arrangements
The provider had improved safeguarding systems since the previous inspection and was no longer in breach of the earlier safeguarding regulation.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 13.” from the report
Risk management
Care plans included risk assessments for areas such as epilepsy, medicines and behaviours that may challenge others. Emergency evacuation plans and safety checks were also in place.
“Sufficient risk assessments were in place to ensure people received safe care.” from the report
Medicines
Medicines were stored securely and records showed people received them as prescribed. Staff had up-to-date medicines training.
“Medicines were being managed safely. Locked cabinets were in place and all medicines and records were safely stored.” from the report
Staffing and training
Inspectors found enough staff with suitable skills and experience. Recruitment checks and training supported safety, including for agency staff.
“There were sufficient staff available with the right skills and experience to meet the individual needs of people who used the service.” from the report
Positive culture
Staff described good relationships and a positive atmosphere. Relatives and people knew who to speak to about concerns.
“There was a positive culture at the home and people benefited from being supported by happy staff and this was reflected in the atmosphere at the home.” from the report
Incidents were not used to prevent harm
seriousInspectors found records of incidents but no evidence that they had been shared with staff or used to reduce future risks. The provider was not following its own accident and incident policy.
“These failures evidenced a lack of learning from events or action taken to improve safety, placing people at risk of harm.” from the report
Weak quality oversight
needs fixingStaff meeting records did not discuss accidents and incidents, even though the provider's own mock inspection had identified this issue. Inspectors recommended reviewing quality assurance systems.
“There was a lack of systems in place to analyse events, accidents and incidents to identify what went wrong so action could be taken” from the report
No registered manager in post
needs fixingThe registered manager had recently left and a new manager was being recruited during the inspection. The area manager and deputy manager were managing the service at that time.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01How are accidents and incidents now investigated, reviewed and discussed with staff?
- 02What changes have been made to ensure lessons from incidents are recorded and used to prevent similar events?
- 03Who is currently responsible for managing the home, and has the new manager started?
- 04What action plan did you send to the CQC after this inspection, and what progress has been made?
- 05How do you check that your quality assurance systems identify and resolve risks promptly?
This was a focused inspection of Safe and Well-led only; the other ratings carried over from the previous inspection. This explanation was written from the published report of 9 September 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, June 2022
Rated Requires Improvement; inspectors found kind, personalised care but weaknesses in incident reporting and service oversight.
Inspectors visited on 5 and 9 May 2022. They spoke with people, relatives, staff and managers, observed care, and checked care plans, medicines, infection control and management records.
People were generally treated with kindness and respect. They had personalised care plans, support to make choices, access to activities and contact with family and friends. Inspectors rated the home Good for effective, caring and responsive care.
The home did not always record or report accidents, incidents and possible safeguarding concerns correctly. This meant managers could miss information needed to review risks and prevent problems happening again. Safe care and leadership were both rated Requires Improvement.
The report says this was the first inspection of the service under the new provider. The previous provider had been rated Good in a report published in 2018.
Kind and respectful staff
People and relatives described staff as kind and caring. Inspectors observed staff supporting people calmly while respecting their privacy, dignity and choices.
“People were well treated and supported.” from the report
Personalised care
Care plans included people's histories, preferences, communication needs, routines and triggers. Staff used this information to provide individual support.
“People received personalised care that gave them choice and control of how they wished to receive their care and support.” from the report
Activities and community contact
People were supported to go into town, attend a day centre and gym, take part in activities, and keep in touch with relatives and friends.
“People were supported to pursue their interests and hobbies that were socially and culturally relevant to them.” from the report
Medicines and infection control
Medicines were stored securely and records showed people received medicines as prescribed. Inspectors also found suitable infection prevention arrangements, including safe use of protective equipment.
“We reviewed MARs and saw evidence that people received their medicines as prescribed, and PRN medicines were given as needed.” from the report
Incidents not always recorded
seriousAt least five incidents were not recorded in the electronic system. This reduced the home's ability to investigate events, learn lessons and reduce the risk of them happening again.
“We did not see evidence that people were harmed. However, we found that some incidents involving people living in the home, were not reported as incidents” from the report
Safeguarding reporting
seriousThe home did not always use safeguarding systems effectively. Inspectors found that the approach to deciding whether incidents should be reported as safeguarding concerns was not consistent.
“We found no evidence people were harmed but systems to report incidents where people were at risk of abuse or coming to harm, were not always used effectively.” from the report
Weak management oversight
seriousThe electronic system did not always alert managers to pain or other medical concerns. Inspectors were not always able to see what action had been taken in response.
“This meant the registered manager was not always aware of what incidents had occurred to review and learn lessons.” from the report
Recruitment records
needs fixingSome staff recruitment files did not contain all the required information, including application forms and references. The report says this was linked to staff transferring from the previous provider.
“However, we noted that some staff recruitment files did not contain all the required information.” from the report
Campus setting
minorThe home was in a secluded campus setting with two other homes. Inspectors said this did not fully follow the current guidance, although people were supported to go out and use local facilities.
“This meant the service was designed in a way that did not embed people in the community and was not in line with the current principles of Right support, Right care, Right culture.” from the report
- 01How do you make sure every accident, incident or episode of self-harm is recorded and reviewed?
- 02How do you decide whether an event must be reported as a safeguarding concern?
- 03What training has staff received on the electronic care monitoring system, and how do managers check that it is being used correctly?
- 04How are pain, illness or other health concerns flagged to managers and followed up?
- 05What is the current position on completing missing application forms and references in staff recruitment files?
This was the first inspection of the newly registered service under the new provider and covered all five rating areas, including infection prevention and control; the previous Good rating was for the former provider in 2018. This explanation was written from the published report of 30 June 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 The Paddocks
5 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- September 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2022Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- August 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- May 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2021
Registered with the Care Quality Commission on 5 March 2021.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Havering
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 £980 to £1,230 a week. 81 can care for a couple. 11 years' experience on average.
“Sidonia is a first class live-in carer whose dedication and thoughtfulness made her stay a happy experience.”
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.