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Inspection report

Date of Inspection: 20 May 2014
Date of Publication: 24 June 2014
Inspection Report published 24 June 2014 PDF

Staff should be properly trained and supervised, and have the chance to develop and improve their skills (outcome 14)

Not met this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by competent staff.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 20 May 2014, observed how people were being cared for and talked with people who use the service. We talked with carers and / or family members, talked with staff, reviewed information given to us by the provider and reviewed information sent to us by other authorities.

Our judgement

People were not cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

Reasons for our judgement

Most people we spoke with talked positively about the staff. Comments included "They are good," "They are very friendly and kind. If I have an issue I take it to the manager and she sorts it out." All the staff we spoke with told us they enjoyed working at Green Trees and felt supported by management. One staff member said "morale is up and down." Another staff member said "we are a good team and all help each other."

We saw that there was an induction programme provided for new staff, which one staff member was currently undertaking, during which they worked alongside more experienced staff in order to develop their skills. Staff records and duty rotas we looked at confirmed this. One member of care staff we spoke with told us they had been supported in completing further qualifications appropriate to their employment at Green Trees, including national vocational qualifications in care and in nutrition. We looked at their personnel records which confirmed this.

The provider had not worked continuously to maintain and improve high standards of care by creating an environment where clinical excellence could do well. Care staff and catering staff we spoke with provided us with examples of recently completed training relevant to their role, but were unable to tell us what their training requirements and responsibilities, including mandatory training, were. We saw that the training requirements were not set out in the staff training policy. We asked to see a training matrix and none was available. The Registered Manager told us there was no formal system in place for monitoring training but that work was in progress to capture this information as part of a new electronic care management system. The Registered Manager told us that some training records were already stored on the new system, which we saw to be the case. We were told by the registered manager that other training records were not available.

Staff and managers we spoke with could not provide evidence of any recent training in dementia care, record keeping or care planning, or moving and handling. We were told that one member of staff had completed recent training in safeguarding, but this was not the safeguarding lead. We looked at staff records which confirmed this. We looked at staff training records relating to the safeguarding of vulnerable adults and saw that although the majority of staff had completed some initial in-house training, only one member of staff had completed a recent update. This was not the person with the specific lead responsibility for safeguarding or training.

We saw that in the last twelve months the majority of staff had completed training to refresh their knowledge and skills in first aid, food hygiene, fire safety and prevention, and deprivation of liberty safeguarding and the Mental Capacity Act 2005. We asked to see the list of staff trained and authorised to administer medicines. This was not stored in accordance with the home's policy, and was not available at the time of our visit. Staff we spoke with told us medicines management training was provided in house. None of the managers we spoke with could recall any recent training on medicines management.

Staff we spoke with were unsure of future training or development plans or timetables. One member of staff said: "we get told what training to go on. I cannot remember seeing a programme." Another staff member said "I would generally like to see more training, in infection control, for example." The provider told us there had been "little training" this year but that there were plans to access more on-line learning.

Staff did not receive appropriate training, professional development, supervision and appraisal. The staff supervision policy stated that all care staff would receive formal supervision four times a year. However, the Registered Manager told us there were no systems currently in place for ongoing supervision or appraisal and that it was not happening. Staff ther