The Green

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.

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 provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported accidents and incidents. Lessons were learnt to continually identify and embed good practice. The provider had established processes for identifying, reviewing and learning from accidents and incidents. These supported a positive learning culture and helped ensure people received safe care. Incidents, safeguarding concerns and risks were reviewed through established governance processes. Leaders considered contributing factors, identified lessons learned and shared learning with staff through handovers, supervision and team discussions. Where improvements were identified, actions were taken, including updating care plans and increasing monitoring of people’s needs and risks. Staff demonstrated an understanding of their responsibilities for reporting concerns and were confident that issues would be acted upon.

The provider 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. A person’s relative told us, “He has lived at The Green for 33 years. I like the care. The main thing is that it has evolved a lot over the years.” We observed people who became worried and distressed where consistently supported and there was a focus on planning for a good day. We saw staff understood people well and monitored any changes that could cause them to become distressed.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. Staff demonstrated they knew what safeguarding meant and how to raise a safeguarding concern and we saw all the staff had received safeguard training.

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. For example, we saw that the provider worked with people to understand any historical challenges such as who was involved in their lives in the past and what impact this had. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risk assessments were in place to guide staff in responding to people's healthcare needs, communication needs, expressing their feelings or displaying signs of emotional distress.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The provider had worked to support people to have individualised living space and designed to promote their independence and privacy.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. Staff recruitment processes were in place with relevant checks of staff’s employment history, character, right to work, and checks with the disclosure and barring service (DBS). Staff we spoke with were very committed and passionate about the work they did at The Green. Staff told us, “Moral is good. Communication from managers is good and there is always enough staff.” Relatives commented their loved ones where safe and staff were trained well, one person said, “The training is good with a very high percentage of training.” We saw that staff had completed the Oliver McGowan training on autism and learning disabilities. This is recommended and essential training and from 1 July 2022, all health and social care providers registered with CQC must ensure that their staff receive training in how to interact appropriately with people who have a learning disability and autistic people, at a level appropriate to their role.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Shared areas of the home as well as people’s own rooms were clean and tidy. The home was clutter free. Staff wore personal protective equipment (PPE) appropriate to their tasks. People were supported to maintain good hygiene. Staff knew about infection prevention procedures which they followed to protect people from risk.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened. Records showed medicines were given safely and as prescribed. Staff received medication training which included training about how to safely administer specialist emergency medicines in case of a seizure. The managers completed audits and had identified additional support for staff.