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, January 2023
Inspected but not rated; the home had improved, but it remained Requires Improvement because governance systems were still not robust.
This was an unannounced, targeted inspection on 13 December 2022. One inspector spent time with people, observed staff interactions, spoke with managers and staff, and reviewed policies, audits, risk assessments and other records.
The inspection followed a warning notice about how the home was managed. Inspectors found improvements in safeguarding, staff training, management structure and provider oversight. However, audits were inconsistent, actions did not always have clear owners or deadlines, and some policies were out of date.
The home remained in breach of Regulation 17, Good governance. The overall rating was not changed by this targeted inspection and remained Requires Improvement. Inspectors did not review the whole Well-led question, so it was recorded as inspected but not rated.
Safeguarding systems
Systems for managing safeguarding concerns and learning from them were in place. Information was sent to external bodies within the required timescales.
“Systems were now in place to manage safeguarding and learn lessons from them.” from the report
Staff support
Systems had been introduced to make sure staff received training to support people's needs and wishes.
“Systems were now in place to ensure staff were receiving appropriate training to support the needs and wishes of people.” from the report
Clearer management structure
The home had a clearer staff structure, with extra senior management support for the registered manager.
“There was now a clear staff structure in the home to support the registered manager to run it.” from the report
Governance remained weak
seriousAudits did not consistently contain enough detail or cover the right areas. Actions did not clearly state who was responsible or when they should be completed.
“Systems were still not robust enough to assess, monitor and mitigate risks to the health, safety and welfare of people.” from the report
Water safety checks
needs fixingAnnual water checks had improved, but temperature checks were not being completed in line with health and safety guidance.
“the water temperature checks were not being completed in line with health and safety executive guidance to ensure the temperatures were safe.” from the report
Out-of-date policies
needs fixingPolicies available to staff were not in line with current legislation and guidance. Some referred to dangerous restraints and training that staff no longer had.
“Policies and procedures available to staff were still not in line with current best practice and legislation.” from the report
Limited provider checks
needs fixingProvider visits did not cover some important areas, including medicines management. This limited the extra oversight of accidents and incidents.
“there were areas the provider was not looking at such as medicine management.” from the report
- 01What has been done to make audits detailed, consistent and focused on people with learning disabilities or autism?
- 02How do you now record who is responsible for each improvement and when it must be completed?
- 03Are all staff policies now current, legally compliant and accessible to staff?
- 04How are water temperatures checked and recorded to make sure they are safe?
- 05How does the provider now check medicines management, accidents and incidents during its oversight visits?
This was a targeted inspection of the warning notice about Regulation 17 and did not assess the whole Well-led question or the other key questions. This explanation was written from the published report of 19 January 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, August 2022
Rated Requires Improvement, with Inadequate leadership; inspectors found kind relationships but serious gaps in safety, training, care planning and oversight.
This was the first comprehensive inspection giving the home an overall rating and ratings for all five areas. Inspectors visited unannounced on 25 May, 29 May and 07 June 2022. They spoke with people, relatives, staff and health professionals, observed care, and checked care, medicine, staff and management records.
The home supported five people with learning disabilities and/or autism. Inspectors found some positive care, including kind staff, support with medicines, activities and family contact. However, care plans were not always personalised, communication needs were not properly supported, and staff did not always recognise or respond to distress.
There were serious concerns about risks, restrictive practices, staff training, consent and the management of the home. Quality checks had not found important problems. The well-led rating fell from Requires Improvement at the previous focused inspection to Inadequate.
The provider remained in breach of several regulations. CQC warned the provider to improve its governance within three months and said it would work with the local authority and return to check progress.
Kind relationships
People were generally treated warmly and respectfully. Staff were described as compassionate, and people had positive relationships with staff and the registered manager.
“People received kind and compassionate care from staff who used positive, respectful language which people understood and responded well to.” from the report
Medicines management
Inspectors found that most medicines processes were followed safely. People were supported to make choices about their medicines where possible.
“Staff followed effective processes to assess and provide the support people needed to take their medicines safely.” from the report
Activities and interests
People were supported with activities and interests that mattered to them, including animals, cooking and going into the community.
“Staff supported people to participate in a range of activities which was in line with their wishes.” from the report
Family and professional involvement
Relatives were involved in care and people were supported to maintain family relationships. The registered manager also worked positively with health and social care professionals.
“During and after the inspection the registered manager demonstrated their willingness to work with other health and social care professionals.” from the report
Safeguarding and restrictive practices
seriousThe home did not have effective systems to protect people from potential abuse. Staff training and guidance about distress and physical restraint were not adequate, and door locks had not been properly assessed as restrictions.
“This placed people at risk of untrained staff using an inappropriate and potentially dangerous restraints in an emergency.” from the report
Incomplete risk assessments
seriousSome newer residents had only short-term plans and missing risk assessments. Inspectors identified risks involving choking, seizures, hoisting, the environment and staff staying at the home.
“People were not always receiving safe care and treatment that managed risks well.” from the report
Staff training
seriousMany staff had not completed important training, including safeguarding, autism awareness, mental health and support for people who became distressed. Agency staff did not receive an induction.
“Systems were not in place to ensure people were supported by staff who had received training to meet their needs.” from the report
Consent and legal safeguards
seriousCapacity assessments and best-interest decisions were missing for some important decisions. Some restrictions on people's liberty were not properly recognised or legally managed.
“Systems were not in place to ensure consent for care and treatment for people who lacked capacity and/or had fluctuating capacity was in line with legislation.” from the report
Poor management oversight
seriousQuality checks did not find important problems, including overdue safety testing and incomplete staff training. The management structure was not strong enough and records were incomplete or delayed.
“Quality assurance systems were not identifying concerns found during the inspection.” from the report
Communication and personalised planning
needs fixingPeople with limited verbal communication did not have alternative communication systems. Some newer people's care plans did not explain their needs, preferences, goals or how staff should support them consistently.
“Two people who lacked verbal communication had no alternative communication systems in place.” from the report
- 01What has been done to complete individual risk assessments and personalised care plans, especially for people who have recently moved in?
- 02Which staff have now completed training in safeguarding, autism, communication and supporting people who become distressed?
- 03How are door locks, physical restraint and other restrictive practices assessed, recorded and reviewed as the least restrictive option?
- 04How do you make capacity assessments and best-interest decisions for people who cannot make particular decisions themselves?
- 05What checks now show that incidents, staff training, safety testing and changes to care are being properly monitored?
This was an unannounced comprehensive inspection covering all five key questions, and it also included infection prevention and control checks. This explanation was written from the published report of 31 August 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
Each visit the CQC has published, newest first, back to the day the home was registered.
- January 2023Inspected but not ratedcurrent ratingWell-led: Inspected but not rated
- August 2022Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- April 2021Inspected but not ratedSafe: Requires improvementWell-led: Requires improvement
- May 2019
Registered with the Care Quality Commission on 9 May 2019.
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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