Background to this inspection
Updated
19 May 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team
This inspection was undertaken by one inspector.
Service and service type
The Green is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
We gave the service 24 hours' notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be someone in, when we visited.
What we did before the inspection:
We reviewed information we had received about the service since the last inspection and contacted the local authority to gain their feedback. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection:
We spoke with two people who lived in the home and three relatives. We spoke with the registered manager, the house manager and two care staff.
We reviewed a range of records. This included three people's care records and a sample of medication records. We also looked at records relating to the management of the service.
No new staff had been employed at the service since our last inspection so we did not need to look at staff recruitment records.
After the inspection
We continued to seek clarification from the registered manager to validate evidence found. We looked at staff support and training data and additional records relating to the management of the service.
Updated
19 May 2020
About the service
The Green is a small care home that provides accommodation for up to ten people living with learning disabilities who require support with their personal care. At the time of our inspection ten people lived at the home.
People’s experience of using this service:
The systems in place to ensure the management of medication was safe, were not robust. The provider’s fire evacuation procedure required review. This was because the procedure did not make it clear how staff would ensure people’s safety if they were unable to evacuate them to a place of safety. Information in people’s care plans was person centred and detailed but not always consistent across their documentation. The governance arrangements in place to audit aspects of service delivery had not identified that these areas required improvement. This meant they were not always effective.
People’s needs and risks were properly assessed and staff had guidance on how to support people appropriately. Peoples wishes and preferences were clearly documented. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People confirmed they felt safe with the staff and that staff were kind, caring and patient. Relatives agreed with this. People’s daily records showed people received the support they needed in accordance with their care plan.
Staff knew people well and spoke with genuine warmth about the people they supported. Staff understood the variety of ways people communicated their wishes and supported them to make day to day decisions. Staff respected people’s privacy and dignity and valued their equality and diversity.
People enjoyed a range of social and recreational activities of their choosing. Some people also undertook work placements in the community and people’s independence was actively supported. Everyone was more than happy with the service they received. Relatives we spoke highly of the staff team, the manager and the support provided.
Staff were recruited safely and received regular supervision and training. Staff felt supported and said the manager and provider were open and approachable.
People were supported to maintain positive relationships with family and friends. Their relatives told us how pleased and reassured they were that their loved ones lived at The Green.
People’s day to day support was 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 services 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/or autism to live meaningful lives that include control, choice, and independence.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 10 people. This is larger than current best practice guidance. However, the size of the service did not have a negative impact on people as the building design mitigated this. The home was split into four separate flats were people lived with a maximum of four flatmates. Each flat had its own communal living space, kitchen/dining area and was personalised to their tastes and preferences.
The manager and house manager were open and transparent throughout our visit. It was clear they had people’s best interests at heart. They understood their regulatory responsibilities and were committed to continuous improvement.
Rating at last inspection
The last rating for this service was good (published 14 September 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.