This inspection took place on 1 August 2018 and was announced. We informed the provider 48 hours in advance of our visit that we would be inspecting. This was to ensure there was somebody at the location to facilitate our inspection. The service was last inspected on 17 February 2016 and overall was rated Good.

The Paddock provides personal care support and practical assistance to older people who live in self-contained flats owned by Methodist Homes. Most of the people who use the service are independent and require little or no support from the service. This type of support is called "Well Being."

The accommodation is rented, and is the occupant's own home. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people's personal care and support service. At the time of our inspection four people living at The Paddock received personal care support.

The service had a registered manager in place. 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 2008 and associated Regulations about how the service is run.

People told us they felt safe at the service. The provider identified risks to people and staff knew how to provide safe care. Staff knew safeguarding and whistleblowing procedures. Staff were knowledgeable in types, signs of abuse and knew how to report poor care, neglect and abuse. However, the management did not always follow appropriate safeguarding procedures. We have made a recommendation in relation to safeguarding procedures. The provider employed sufficient and suitable staff to meet people’s needs safely. People were appropriately supported with their medication needs. The service was clean and staff were trained in infection control procedures. Accident and incident records were maintained but the provider did not always document lessons learnt.

People’s needs were assessed, staff knew people’s abilities and people told us their needs were met. Staff received regular training and supervision that enabled them to meet people’s needs effectively. People’s nutrition and hydration needs were met. Staff supported people to access healthcare services when this was requested. People told us staff offered them choices and asked their permission before helping them.

People told us staff were caring and friendly. Staff were trained in equality and diversity and treated people with dignity and respect. People’s religious and cultural needs were recorded in their care plans and met by staff. The provider encouraged LGBT people to use the service.

People’s care plans were comprehensive and their care files had life story books that gave information on people’s likes and dislikes. Staff knew how people liked to be supported. People and their relatives were involved in their care planning and review meetings. People and relatives were encouraged to make complaints. However, the management did not always follow the provider’s complaints policy whilst addressing people’s complaints.

The provider had monitoring and auditing systems in place to check the safety and quality of the service. However, they were not always effective in identifying gaps and errors. People, relatives and staff told us the management was approachable and had seen improvement since the new registered manager. People’s, relatives’ and staff’s feedback was sought and considered to improve the service.

We found the registered provider was not meeting legal requirements and there were two breaches of the Health and Social Care Act 2008 (Regulated Activities) regulations. These were in relation to acting on complaints and good governance.

Full information about CQC's regulatory response to any concerns found during inspec

The inspection took place on 17 February 2016 it was an announced inspection. At the previous inspection in 17 December 2013 there were no breaches of regulations.

The Paddock provides support and practical assistance to older people who live in self-contained flats owned by Methodist Homes. Most of the people who use the service are independent and require little or no support from the service. This type of support is called “Well Being.” A small number of people receive care and support throughout the day to meet their assessed needs.

There is a registered manager. 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 2008 and associated Regulations about how the service is run.

During our visit we met with and talked with the newly appointed manager who will be applying for the role of registered manager once his probation is completed. The current registered manager will then concentrate on managing another service. The registered manager was not available to speak with on the day of inspection so we spoke with the registered manager following the inspection.

People and their relatives told us that they felt safe with the care staff. Staff were trained in safeguarding adults and understood how to protect people from

abuse.

People and their relatives had been involved in the planning of their care and received care and support in line with their plan of care. People who needed help with their medicines received the help they needed.

Risks to people were minimised because there were arrangements in place to manage identified risks with people’s care.

There was enough staff to meet the support needs of people receiving care and support from the service. Recruitment checks were carried out prior to staff starting work to ensure their suitability to work with people who used the service.

Staff gained people’s consent before providing care and ensured people were supported to make day to day choices. Arrangements were in place to ensure that staff understood the principles of the Mental Capacity Act 2005(MCA) and Deprivation of Liberty Safeguards (DoLS).

People were able to raise concerns but did not always feel complaints were resolved. The service did not analyse complaints to identify trends.

Most people were happy with the service they received and told us staff were caring. There were day to day arrangements in place to monitor the quality of the service provided. However we did not see evidence of consistent measures to understand people’s and staff experiences of the service.

People told us that they were involved in decisions and the design making processes in relation to their care and support needs. People who used the service expressed positive comments to us such as "staff are very nice" and "we get on well with staff." Support plans were personalised and had taken into account people's views. Support plans had been reviewed.

We were able to review four records related to people's care and support needs. We saw that these records were individualised and person centred.

Staff had access to training such as safeguarding. There were effective recruitment procedures in place so that people could be confident the right people were employed in the service.

People were able to leave comments and feedback in a book which was kept at reception. All comments and feedback we saw were positive. People who used the service told us that they were asked for their views about their care and they were acted on by staff.

We spoke with four people using the service, two care workers and examined the files for three people using the service and three care workers.

All the people we spoke with told us they were happy with their individual care arrangement. One person said: "If I was unhappy, I would probably know what to do." People told us they liked being independent and having the opportunity to ask staff for support if or when the need arose. People told us care staff were "kind" and "listened" to them. They told us they knew how to make a complaint but had nothing to complain about.

We noted that people could choose to order or prepare their own meals. People using the service were visited by their relatives, advocates and people who provided spiritual service. This meant that people could share their personal or individual needs with other people if they needed.

People told us they valued having care staff and other people around. They told us they did not feel lonely or bored. All the people we spoke with told us that they felt safe living at the service. They told us they attended monthly meetings and had been consulted about how the service could be improved.