The Paddocks Also known as previously Wilsic Hall College

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

The provider was previously in breach of the legal regulation in relation to safe management of medicines, assessing risks to health and safety. Improvements were found at this assessment and the provider was no longer in breach of this regulation. The registered manager had taken action to ensure the safe management of medicines, infection control and risks to people’s health and safety in the service.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. The provider encouraged a culture of communication, honesty in admitting mistakes and transparency. This helped to mitigate the risks associated with closed cultures. A closed culture is a poor culture that can lead to harm, including human rights breaches such as abuse. The management team encouraged visits to the service and listened to any issues raised by people, their relatives and advocates, and staff.

We asked people and their relatives if they felt the service had a culture of openness and honesty. People told us they did. One relative said, “Yes, they tell me about all the things that are going on in [person’s] life.” Another relative said, “I have always been kept informed about things.” Although, another relative said that last year, staff had forgotten to tell them about an incident, which had undermined their trust a little. We discussed people’s feedback with members of the management team, all of whom told us they continued to work positively with the person and their relatives, alongside the partner professionals funding the person’s placement.

Systems were in place to make sure concerns were investigated, and lessons learnt to identify and embed good practice. Any lessons and consequent changes were relayed to staff via on-line bulletins and through regular handovers, meetings, and supervision sessions.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People had information that was specifically designed to help healthcare professionals and services to understand their needs and preferences, and ways of communicating. This was to help make sure they received the care they needed if they had to go to hospital.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. Staff had appropriate training in safeguarding people from abuse and were aware of actions to take to safeguard people.

The registered manager had good knowledge of safeguarding and reporting procedures. During our site visits we saw staff treated people respectfully and supported people to remain safe. Feedback from people and their relatives was positive. A relative said, “It's a safe place for [person] and its bespoke.” Another relative said, “We feel [person] is safe, and we have never had any issues in that area. We visit regularly. If we don’t visit, [staff] bring [person] to us. We chat every day on Face-time.”

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS).

We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.

The service provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. One person said, “I have choices, and I can go to London on my holidays.”

There was a focus on planning and understanding what caused people distress to facilitate positive change. Staff received training and support in the use of positive behaviour support (PBS). This is a person centred framework for providing support to people with a learning disability, and/or autism, including those with mental health conditions, who have, or may be at risk of developing, behaviours of distress.

The service employed consultant specialists in areas such as psychiatry, psychology, and occupational, and speech and language therapy, supporting this positive approach, and helped to make sure people were consistently supported when they were distressed.

Where people communicated their needs or feelings through their behaviour they had individual, positive behaviour support plans. These supported staff to provide care that mitigated known risks and included ways to avoid or minimise the need for restricting people’s freedom. Incidents were reviewed and learned from to help reduce restrictive practices. One relative told us this approach had been very successful for their family member. They said, “I think [person] is safer here because they don't have behaviours anymore. [Person] has not displayed any behaviours for years.”

Staff were kept up to date with any changes in people's support during handovers and team meetings and information available on the electronic records system. People's risks were assessed at regular intervals or as their needs changed.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. There were systems in place to monitor the safety and upkeep of the premises. Regular checks were completed by the provider to make sure the environment and equipment was safe for people to use.

People lived in small houses and single person apartments on the site. The provider invested a lot of time, effort and resources into making sure people lived in an environment that matched their individual preferences and needs. Where people needed alterations to keep them safe this was done in the least obtrusive way, to maintain a homely feel to the environment people were living in. People and their relatives felt the environment was safe and well maintained. Although, a relative felt there should be more security upon entering and leaving the service. We discussed this with the management team and were assured people were kept safe.

Safe recruitment procedures were in place, and the provider made sure there were enough staff, to meet people’s needs. The provider made sure staff had training, skills and competence to understand and meet the needs of autistic people and people with a learning disability.

People and relatives said they felt there were enough staff to meet people’s needs. They spoke positively about the staff team. One person told us, “I always have staff with me.” Another person said, “I feel safe with the staff, they look after me”. One relative said,”[Person] is well looked after and settled. Staff speak to [person] like an adult and treat [person] good.” Another relative said, “Staff explain to me all the risks and I feel they like [my family member].”

When people received one to one support, the staff’s skills and experience had been matched to the needs of the person to enable people to work towards and achieve their aspirations and potential. Relatives’ comments included, ”Staff are there all the time. It usually is the same staff. I have never had any issues with the staff” and, “I think there are enough staff to meet [person’s] needs.”

The service assessed and managed the risk of infection. The provider had policies and procedures regarding infection prevention and control (IPC) and had systems in place to monitor practice. There were arrangements in place to make sure the environment was cleaned at regular intervals. Staff used personal protective equipment (PPE) appropriately and when required.

We saw no issues with cleanliness or infection control during our visits. The environment was well maintained, and staff supported people to keep their houses and flats clean and tidy. One person told us, “I like to help to make my room safe clean and comfortable. I vacuum, wash up and help clean. This is my choice.”

The provider had made improvements in relation to the safe handling and recording of medicines, and systems and processes were in place for their safe storage and administration. The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

Staff received training in administering medicines and their practice and competence was assessed. People’s medicines and treatments were safe and met people’s needs, capacities and preferences and there were clear processes in place for the use of emergency medicines, such as epilepsy rescue medicines. People were happy with the support they received. One person said, “Yes. Staff have always got my medication. My medication goes wherever I go.” Another person told us, “ I get help to take my medicines and If I am ill staff help me.”

The provider understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both) and made sure people's medicines were reviewed by prescribers in line with these principles.