The Paddocks Also known as previously Wilsic Hall College

The Paddocks is a residential care home providing accommodation and personal care to 5 people at the time of the inspection. The service can support up to 8 people.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right support:

The Paddocks was located in a rural area of Doncaster and people were able to access community facilities and had links with local villages and shops. The location enabled and supported people to access nature and countryside walks. The registered manager ensured there was a culture of person-centred care and support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right care:

Care was person-centred and promoted people's dignity, privacy and human rights. Education and learning were promoted. Medicines were not always managed safely and information was not always correct in medication sheets. Risk assessments were in place and detailed, however, plans were not always followed by staff. For example, where people were at risk of ingesting hazardous substances, cleaning products were not always locked away. Some parts of the service were not clean enough and presented a risk to infection prevention and control. The provider was in breach of regulations in relation to safe care and treatment. Following the inspection, the registered manager took immediate action to address the areas that needed improvement.

Right culture:

The ethos, values, attitudes and behaviours of leaders and care staff ensured people using services were leading confident, inclusive and empowered lives. There was a positive culture of person-centred care for people living at The Paddocks. People were engaged and involved in developing and improving their homes and the service. Families told us they are involved in care planning and reviews and said they were satisfied with communication and engagement from the service. Families felt that the staff promoted a safe, consistent and predictable atmosphere which met people's individual needs and told us the registered manager was approachable and good at listening. Compliance and quality monitoring systems needed to be further strengthened and embedded into practice. The outcomes of audits and checks and needed to be regularly reviewed to identify compliance, lessons learned and areas for improvement. The provider was in breach of regulations in relation to governance of the service. Following the inspection, the registered manager took immediate action to address the areas that needed improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 2 June 2021) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

At this inspection we found the provider remained in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 26 April 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the governance of the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Paddocks on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to medicines management, safe storage of cleaning products and governance of the service.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The Paddocks is a residential care home providing accommodation and personal care for up to 8 young people, as part of a residential college of adult education.

People’s experience of using this service and what we found

The provider failed to have effective systems and processes in place to assess, monitor and improve the quality and safety of the service.

Audits needed strengthening and embedding into practice. Some area infection control issues and some areas of the home were found to not be sufficiently clean; this was addressed immediately.

The registered manager needed to ensure safeguarding concerns were reported to the local authority safeguarding team before being investigated internally. We raised three safeguarding concerns during the inspection.

We received mixed feedback on the service from relatives and professionals.

People were safe from the risk of abuse as staff had good knowledge and understanding of safeguarding.

People received their medicines as prescribed. Accidents and incidents were reported including actions taken.

People were supported by enough staff who had employment checks undertaken prior to starting with the service.

Staff received regular supervisions and appraisals and felt very supported by the registered manager.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• The setting at The Paddocks was based in a rural location in Doncaster rather than being community based. People were still able to access community facilities and had links with local villages and shops. The location benefited people being able to access nature and countryside walks.

Right care:

• Care was person-centred and promoted people’s dignity, privacy and human rights. People were supported in the least restrictive way and education and learning was promoted.

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensured people using services were leading confident, inclusive and empowered lives.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 24 April 2020).

Why we inspected

The inspection was prompted in part due to concerns found in other services run by this provider. These were identified by other professionals and included people’s safety, staff culture and governance. A decision was made for us to inspect and examine those risks. We widened the scope of the inspection to become a comprehensive inspection which included looking at the key questions of safe, effective, caring, responsive and well-led.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report. The provider took action to mitigate the risks following the inspection.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The Paddocks is a residential care home providing personal care for up to eight young people, as part of a residential college of adult education.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them. The college accommodation is in two student houses, situated in the grounds of Wilsic Hall school and fitted in well with the school campus.

The service consistently applied the full range of the principles and values of Registering the Right Support and other best practice guidance. The principles and values of Registering the Right Support ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

Outcomes for people reflected the principles and values of Registering the Right Support. This was by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People’s experience of using this service:

Students were safe and protected from avoidable harm and relevant risk assessments were in place. The students we spoke with told us they felt safe living in the service. Students' medicines were managed well, and the home was clean and tidy throughout.

There were enough staff and they had been recruited in a way that helped to keep students safe. There were enough staff on duty to ensure students’ needs were met. All staff received appropriate training, support and supervision.

Students were supported to eat and drink. Where students had specific dietary needs, these were provided for. Communication was effective within the staff team and students were supported to access healthcare services as needed.

Students were supported to make day to day choices and decisions about their lives and were able to participate in their hobbies and interests. Students were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff were kind and caring towards the students they supported and had developed very strong and positive relationships with them, knowing them well, including their histories, likes and dislikes. Students were treated with dignity and respect, they were involved in making daily decisions and encouraged to develop and maintain their independence.

Care plans were personalised and detailed. They included information about students’ preferences and abilities. Staff supported students to participate in a range of activities. There was a focus on treating students with equality and on involving and empowering those with communication difficulties, to ensure their voices were heard and valued. There was a system in place to manage complaints.

Leadership and management were of good quality and the young people who used the service, their relatives and representatives were involved in how the service was run and operated. Systems of governance were in place to monitor the quality of the service provided and staff felt supported and spoke positively about the registered provider and the registered manager.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

The service was rated good at the last inspection in July 2017 (published September 2017).

Why we inspected:

This was a planned inspection based on the rating awarded at the last inspection.

This inspection took place on 26 and 27 July 2017, and was unannounced on the first day. This meant no one connected with the service knew we would be visiting the home that day. The home was previously inspected in July 2015 when we rated it as ‘Good’.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Wilsic Hall College’ on our website at www.cqc.org.uk’

The service had a registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run.

All the people we spoke with told us they were very happy with the care and support provided at the service, and the way staff delivered that support.

Systems protected people from the risk of harm. Staff were knowledgeable about safeguarding people and were able to explain the procedures to follow should any concerns be raised.

People were encouraged to be as independent as possible, while staff took into consideration their wishes, and any risks associated with supporting them. Support plans and risk assessments were robust and internal systems were in place to enable the management team to get a clear overview of potential risks to people, so these could be managed effectively. However, not all support plans had been evaluated in line with the provider’s expectations.

People received their medications in a safe and timely way from staff who had been trained to carry out this role.

The recruitment system helped the employer make safer recruitment decisions when employing new staff. New staff had received a comprehensive induction, which included essential training, at the beginning of their employment. An on going training and support programme ensured staff maintained and developed their knowledge and skills.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

People were involved in planning, shopping for, and helping to prepare their own meals, with assistance from staff when needed.

Wilsic College provided a very caring environment for people to live in. Staff spoke passionately about supporting people to develop their skills and meet their full potential. We found they had used innovative methods to help individual people get over their fears and develop new skills and abilities.

People had access to social activities and education which was tailored to their individual needs and interests. People commented positively about the way staff supported people to develop their skills and knowledge

The provider had a complaints policy to guide people on how to raise concerns and there was a structured system in place for recording the detail and outcome of any concerns raised. This was also available in an easy to read version that used pictures to help people understand the process.

The registered manager and care team demonstrated a commitment to continually improve the service and use lessons learned to take the service forward. There were systems in place to enable people to share their opinion of the service provided. We also saw audits and checks were regularly undertaken to make sure company policies had been followed and the premises were safe and well maintained.