This inspection took place on 5 June 2018 and was unannounced.
Green Trees is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. Green Trees accommodates up to 16 people. On the day of the inspection, there were 14 people living at the home.
When we last inspected, we found breaches of legal requirements in relation to person centred care, assessing risks associated with people’s care, safeguarding people from abuse and not notifying CQC of important incidents.
Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions to at least good. At this inspection, we found that the provider had made improvements to address most of the concerns identified. However, we found that there was further improvement required to ensure people received care which met their emotional and social needs.
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.
We saw that improvements had been made to the provision of activities for people. However, we received feedback that on days when there were no activities, people were not stimulated. We also found provision had not been made to support people to access the community if that was something they wanted to do.
People told us they were well treated at the home and risks to their safety had been identified and ways to mitigate these risks had been recorded in people's care plans.
Staff were aware that the people they supported were vulnerable and they understood their responsibilities to keep people safe from potential abuse.
There were systems in place to ensure medicines were handled and stored securely and administered to people safely and appropriately.
The home maintained adequate staffing levels to support people.
We saw friendly, caring and supportive interactions between staff and people and staff knew the needs and preferences of the people using the service. Care plans were person centred and reviewed regularly.
People told us they enjoyed the food provided and that they were offered choices of what they might want to eat.
People had regular access to healthcare professionals such as doctors, dentists, chiropodists and opticians.
We saw evidence of staff induction and an on-going training programme. Staff had regular supervisions and annual appraisals. Staff were safely recruited with necessary pre-employment checks carried out.
Quality assurance processes were in place to monitor the quality of care delivered. Required statutory notifications had been submitted to CQC.