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Green Trees Care Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 21 April 2017

This inspection took place on 1 March 2017 and was unannounced. At our last inspection on 24 February 2015, the service was rated ‘Good’.

Green Trees Care Home provides accommodation and personal care for a maximum of 16 people. It is a family owned home for older people, some of whom may have dementia. On the day of the inspection, there were 15 people using the service.

There was a registered manager in post. 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 were not always safeguarded from abuse and avoidable harm as the provider had not notified the local safeguarding authority of safeguarding concerns. The provider did not notify CQC of two known safeguarding concerns.

Although scheduled activities took place on some days, we found that people were sitting in the lounge with little interaction or stimulation. There were sufficient staff on duty to ensure people’s needs were met, however, we observed that people were left unsupervised for periods of time. There were a number of occasions during the inspection when staff did not interact with people.

Risks associated with people's care and support needs had been identified and these had been assessed, giving staff instructions and directions on how to safely manage those risks, However, we saw that people’s risk assessments were not always followed.

There was a complaints procedure in place and complaints were investigated. However, some people told us that they did not know how to complain.

Safe medicine management systems and process were in place to ensure that people received their medicines safely and as per their needs and requirements.

Care plans were detailed and person centred and updated regularly.

All staff had received training on the Mental Capacity Act (2005) and understood the importance of obtaining consent from people. Where people’s liberty was deprived, the appropriate authorisation had been applied for which was recorded on people’s care records.

People told us that staff were caring. People told us they could choose their own routines and staff supported them to maintain their privacy and dignity.

Mealtimes were relaxed and people were offered a choice with alternatives offered.

Safe recruitment and selection procedures were in place. Staff were supported with regular training and supervisions. Annual appraisals were not documented.

People were supported to access healthcare.

Quality assurance systems were in place to monitor the safety and quality of care provided. People, relatives and staff were invited to completer an annual satisfaction survey.

Staff and resident/relative meetings did not take place.

Inspection areas

Safe

Requires improvement

Updated 21 April 2017

The service was not always safe. Staff were knowledgeable about how to safeguard people from abuse; however the registered provider had not alerted the local safeguarding authority to safeguarding concerns.

Robust risk assessments were in place for people, however we found that they were not always being followed to ensure people’s safety.

Medicines were managed safely.

Safe recruitment practices were followed ensuring all appropriate checks were completed prior to care staff starting work at the service.

We found staffing levels sufficient; however people were left unsupervised for periods of time

Effective

Requires improvement

Updated 21 April 2017

The service was not always effective. Staff had access to regular training and supervisions which supported them to carry out their role. However, staff did not receive an annual appraisal.

People were given the assistance they required to access healthcare services and maintain good health.

All staff had received training on the Mental Capacity Act (2005) and understood the importance of obtaining consent from people.

We received positive feedback from people regarding the food choices on offer.

Caring

Requires improvement

Updated 21 April 2017

The service was not always caring. We observed that at times there was a lack of staff interaction with people.

Care plans contained information regarding people’s backgrounds, family, likes and dislikes.

People’s privacy and dignity was respected and people could choose their own daily routines.

Responsive

Requires improvement

Updated 21 April 2017

The service was not always responsive. On days when there were no planned activities, people were brought into the communal lounge and left to watch television with little stimulation.

Complaints were logged and responded to. However some people told us they were not familiar with the complaints procedure at the home.

Care plans were detailed and person centred and updated on a regular basis.

Well-led

Requires improvement

Updated 21 April 2017

The service was not always well led. The provider did not submit all required statutory notifications to CQC.

Staff were positive about the management and support they received.

The provider had a system for monitoring the quality of care with regular audits and a yearly feedback survey.